Student Reimbursement Form

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

Are you a current FSU employee?

Mailing Information:

Please note for non-employees, the address you provide on this form is the address the reimbursement check will be sent to.

If you are a graduating senior or moving soon, we suggest using a different address than your current apartment in Tallahassee as the time for reimbursements to be approved, processed, and delivered can take up to 4 weeks.

ADD EXPENSE DELEGATES

Because you checked "yes" to being a current FSU employee, you must complete the following steps in addition to submitting this form.

Follow the steps below to add Katie Hansknecht and Johnathan Brown as 'Expense Delegates' in Concur.

  1. Go to my.fsu.edu
  2. Click on the Concur icon
  3. Select:
    "Profile" > "Profile Settings" > "Expense Delegates" > "Add"
  4. Enter ks15g@fsu.edu to add Katie Hansknecht and check the boxes: “Can Prepare”, “Can Submit Requests”, “Can View Receipts” and “Can Preview for Approver”.
  5. Next add Jonathan Brown by entering jbrown@dedman.fsu.edu and checking the same boxes.
Is this reimbursement for The Little Dinner Series?
Please provide the date and name of your dinner:
Please complete the following table for each expense that you are claiming.
Expense Category Description Vendor Date Purchased Amount

Receipt Attachments

Original receipts must be attached for all expenses. All receipts must show the items purchased and amounts, payment method, and date of purchase. Receipts missing this information will not be accepted. 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 and in accordance with Florida State University and/or course policy.

CAPTCHA
5 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.