Non-Travel Expense Reimbursement Form

Please submit this form within 30 days of incurring the expense(s).

Name
Please complete the following table for each expense that you are claiming.
Expense Category Description/Business Purpose Vendor Date Purchased Amount

Receipt Attachments

Original receipts must be attached for all expenses. All receipts much show the items purchased and amounts, payment method, and date of purchase. Incomplete or inaccurate forms may delay reimbursement.

Please attach all allowable receipts that you are claiming for reimbursement.

  • Multiple files allowed
  • 256 MB limit
  • Allowed types: pdf, doc, docx, png, jpg, jpeg

Acknowledgement

By typing your name below, you are declaring that all the information provided in this form is accurate and complete, and that all expenses claimed were incurred for legitimate business purposes in accordance with Florida State University's reimbursement policy.

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