Travel and Expense Reimbursement Form

Travel and Expense Reimbursement Form
Expense Form

COBRA Swim Club recognizes that Staff, Officers and occasionally Members of COBRA Swim Club may be required to incur expenses from time to time in order to conduct Club related business. Please ensure you have reviewed OPS-013: Travel Expense and Reimbursement Policy for eligible and ineligible expense details.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What type of expenses are you submitting?

Non-mileageMileage

Non-Mileage and Expense Details

Expense Reports are to be submitted no more than 30 days from the date the expense was incurred

Non-Mileage Expense Details*

Mileage Expense Details (calculated at $0.62/km)*

Upload a copy of receipts and / or credit card statements clearly highlighting the expense item.

Ensure the specific line items for reimbursement are clearly indicated
Cancelof
How would you like your expense re-imbursed?*

Credit your family accountE-Transfer (auto deposit only)Cheque
Agreement

I certify that the expense information entered above are valid and true
Signature

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Expense Form