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Company Card Expense
Non-Fuel Purchases
10
Questions
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1
Employee Name
*
This field is required.
First Name
Last Name
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2
Date of Purchase
*
This field is required.
-
Date
Year
Month
Day
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3
Purchased From
*
This field is required.
Vendor or company the items were purchased from
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4
Receipt Total
Total $ Amount
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5
Last 4 digits of card used for purchase
*
This field is required.
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6
Purchase Categories - Select ALL that apply
*
This field is required.
Auto - Fuel
Auto - Maintenance
Office Supplies
Office Furniture & Computers
Building/Apartment Maintenance Supplies
Tools & Equipment Purchase
Equipment Rental
Food
Inventory/Supplies for Customer Projects
Marketing/Advertising
Software
Other - See item description
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7
I certify
*
This field is required.
I certify that all information entered above is valid and true.
I certify that the total on the receipt matches the total calculated in this form.
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8
Upload Receipt Here
*
This field is required.
Drag and drop files here
Select files to upload
Max. file size
: 15.5MB
Browse Files
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9
Please verify that you are human
*
This field is required.
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10
Signature
*
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Clear
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