Fillable Revisedofficialfunctionform March 2019 - Revised Official Function Form 02-04-15

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Revisedofficialfunctionform March 2019 - Revised Official Function Form 02-04-15

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
To: VicePreside
ntfor
AdministrationandFinance
From:
Date:
Subject: RequestforReimbursement
Reimbursement for meal expenses incurred as an official University host is requested.An original itemized
receipt(s)isattached.Theexpenseswereincurredin(nameoftown)

IndexCode‐Fund‐Organization‐Account‐ProgramCodeNu
mbers Amount

IndexCode‐Fund‐
Organization‐Account‐ProgramCodeNumbers Amount
JustificationforMealExpense:
ListofParticipants(firstandlastname):

SignatureofRequestorSignatureofDepartmentHead
PrintedNameofRequestorPrintedNameofDepartmentHead
VendorNu
mbe
rofRequestorSignatureofDean(Ifapplicable)

PrintedNameofDean
ApprovedforPayment:
SignatureofChancellor–OzarkCampus
(requiredforallOzarkCampusemployees)
VicePresidentforAdministrationandFinance
Travel Services
203 West O Street
Russellville, AR 72801-2222
479-356-6209
travel@atu.edu
Revised January 2017
This section must be completed for payment processing.
Requestor Home Address:
Street Address/PO Box: _______________________________
City: ___________________________ State: ___________
Zip: __________________
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Revisedofficialfunctionform March 2019 - Revised Official Function Form 02-04-15

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Completed 25 May 2020

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