AP
E:\Web\Forms\AP\Emp_Exp_Report.doc
Form Ref V4 150110
Employee Name:
Phone No:
Does this claim relate to a previously issued advance? (please indicate
) No Yes - please enter amount of previous advance: $
Does this claim relate to Travel on University business? (please indicate
) No Yes - please enter Travel Portal Requisition No.
DETAILS OF CLAIM – Enter all amounts in AUD
Purpose of Expenditure
Amount
GST Amount
(if applicable)
Section
Account
Project
Group
Activity
Location
EMPLOYEE EXPENSE PAYMENT BENEFIT DECLARATION PAYMENT APPROVAL
Note: Some expenditure approved as official University business may still be
subject to Fringe Benefits Tax (eg. HECS, telephone rental, etc.)
Date Entered:
E
E
M
M
P
P
L
L
O
O
Y
Y
E
E
E
E
E
E
X
X
P
P
E
E
N
N
S
S
E
E
R
R
E
E
P
P
O
O
R
R
T
T
Note: Original Tax Invoice/Receipts &/or documentation MUST be attached
The above expenses I am claiming for reimbursement were incurred by me during the
period to for the purposes mentioned above, on official University
business. I also declare that the percentage of those expenses incurred in earning my
assessable income was __ %. Original documentation is attached.
I approve the above expenditure within my delegation as an Authorised Officer.
I confirm that it has been incurred in accordance with University policy and procedures, and is for
legitimate University Purposes.