GOODS & SERVICES FORM

GOODS & SERVICES FORM
Participants are asked to complete this form to ensure accurate accounting of industry contributions to the foreign market development program. The information provided enables USAPEEC to report qualifying expenses and reflect the industry’s level of support.

All information will remain confidential and used only for authorized reporting purposes.
Event
Event Location
Travel Cost
Includes airfare and/or auto use at $0.655 per mile or cost of any other mode of roundtrip transportation.
Registration Fee
Meals
Hotel
Taxi / Other Expenses
Time Spent in Hours
This amount includes hours spent in travel and up to a maximum of 20 hours in attendance at meetings.
Name

First NameLast Name
Company Information

Company NameTitle
Email
example@example.com
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature
Date

MonthDayYear
Date
Should be Empty: