Student Reimbursement Request Form

Student Reimbursement Request Form
Team Name:
IMPORTANT:
If all your line items are less than $150, you may get a reimbursement using a Petty Cash Form. You can go to: Cash Reimbursements for instructions and the link to the form OR you may pick up a petty cash from the from the OEDK, outside of Room 103, the instructions are attached. Thank you.

Are you an OEDK Funded Team AND your orders are processed through the OEDK?
IMPORTANT:

If you are NOT funded through the OEDK, please submit your reimbursement request to your funding department. If your orders are not processed through the OEDK, we cannot process your reimbursement either. Thank you.
Name of Team Member being Reimbursed:

First NameLast Name
Student ID # OR Person #:
iO Supplier Number (if available):
Please enter your iO supplier number if you have one. If don't have one, we will be requesting this for you in order to process your reimbursement.
Email
example@example.com
Do you have Direct Deposit with Rice? (Direct deposit is preferred. You may sign up for Direct Deposit through your iO Account.) PLEASE MAKE SURE TO UPDATE ALL YOUR INFORMATION IN YOUR IO ACCOUNT, AS THAT IS THE INFORMATION THAT WILL BE USED FOR YOUR PAYMENT PROCESSING.
OUT OF POCKET PURCHASES:

-You must include the Transaction Dates, Vendors, Description of Expenses and total for each receipt in an Excel spreadsheet. These expenses must match your receipts.
-You will NOT be reimbursed for any taxes paid.
-There is only ONE reimbursement per team, per semester, paid out to ONE team member.
Add a spreadsheet of expenses here:

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Total to be Reimbursed:
RECEIPTS:

-Attach original, itemized, paid receipts as pdf files.

-You may combine mulitple receipts into 1 file, but please DO NOT EXCEED 6 receipts per PDF file.

-Any sales tax paid will NOT be reimbursed.
Add your receipt(s) here:

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Comments:
Should be Empty: