CTS Fleet Fuel Expense

CTS FLEET • Fuel Expense Submission

*If you used your CTS company card, you do not need to fill out this form in addition to Concur.*
I am submitting
How are you submitting the Missing Receipt Form?
Upload CTS Missing Receipt Form Below

Reference instructions on how to fill out Missing Receipt Form on the second tab of the form.

Missing Receipt Form is to be completed only if the actual itemized receipt is not attainable for a transaction. Use of this form in lieu of an actual receipt should be a rare exception, not the rule. Overuse/abuse of this from may result in disciplinary action.
Photo of Fuel Pump:
Photo of Receipt:
Missing Receipt Form

Upload screenshot or file here.
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Missing Receipt Form

Missing Receipt Form is to be completed only if the actual itemized receipt is not attainable for a transaction. Use of this form in lieu of an actual receipt should be a rare exception, not the rule. Overuse/abuse of this from may result in disciplinary action.
Photo of fuel pump:
Total Cost of Fuel:
Project Name:
Project Code:
Vehicle
What was fuel purchased for?
Name

First NameLast Name
Email:
Ensure email address is entered accurately.
Fill out this section only if info below is illegible on receipt.

Please verify that receipt photo contains the below information. If it doesn't, enter info below.
Vendor:
Name of gas station
Vendor Location:
Purchase Date:

MonthDayYear
Date
Last 4 Digits of Card:
Reason for missing receipt:
What attempts have been made to recover missing receipt?
Optional Notes:
By signing below I certify:
• No original receipt is available,
• The amount of the expense is accurate,
• I have attempted to obtain an itemized receipt from the merchant/vendor,
• The items above were purchased on/for approved CTS business,
• and I have not received reimbursment for any portion of these expenses.
Signature
Should be Empty:

CTS FLEET • Fuel Expense Submission

Fill out this section only if info below is illegible on receipt.