Expense Claim Form 10.E - 10. Forms & Miscellaneous - E: Expense Claim

Expense submitter details

Expense claims & receipts are to be submitted to the OSA Treasurer within 60 days of the event or claim could be declined. Initially claims & receipts can be submitted electronically, but original copies of claim form receipts need to be sent to the OSA Treasurer within 60 days.

All claims are to be submitted in Canadian dollars.

Name*

First NameLast Name

Position*

Phone Number*

Area CodePhone Number

Your Email*

example@example.com

Expense details

Date of expense / event*

Date

Reason for Expense*

If Other, please list reason for expense:

Travel
Mileage is expressed in kilometers including return trip and expense claims are processed @ 0.50 cents per kilometer.

Claim either mileage or fuel with receipt, not both.

Travel claims*

Not applicableEnter travel expense

Choose type of claim

MileageGas with receipt

Mileage traveled

Amount in KM

Claim ( Mileage multiplied by 0.50 )

Calculated amount in CAD

Gasoline (with receipt only)

Enter amount in CAD

Claim amount per km

Travel from

To

Travel Direction

One wayReturn

Shared travel with (if applicable)

Accommodation

Reimbursement is based on 2 people per room. If you choose not to share you will be responsible for one half of the cost of the room.

Accommodation claims*

Not applicableAdd accommodation expense

Shared Accommodation with*

Claiming # of nights*

$ per night*

Amount in CAD, Total to incude taxes

Claim Total

Amount in CAD

Meals

Expenses are reimbursed for the total receipts, up to the maximum allowable, whichever is lowest. Unjustifiable meals will not be reimbursed (i.e., meals included at function – indicate as “provided”).

Daily expense guideline:
Daily total of $60.00 excluding alcoholic beverages

Meal claims*

Not applicableEnter meal expense

Date 1

Date

Rows	Breakfast	Lunch	Dinner	Subtotal
Meals

Date 2

Date

Rows	Breakfast	Lunch	Dinner	Subtotal
Meals

Date 3

Date

Rows	Breakfast	Lunch	Dinner	Subtotal
Meals

Total meal costs

Other expenses
(Specify and total on a different sheet)

Other claims*

Not applicableEnter other expense

Other costs

amount in CAD

Remarks about other expense

Advances
It is easy to forget we ever received a float or an advance by the end of the term, so please note below if a prior advance needs to be applied to this expense claim.

Advances to be deducted*

Not applicableEnter advance amount

Advance to be applied

amount in CAD

Advance received on

Date

Automated Summary of Expenses

Mileage

Mileage amount in CAD

Fuel amount (attach receipt)

Gas amount in CAD

Accommodation

amount in CAD

Meals

amount in CAD

Other

amount in CAD

Advance amount to be deducted from claim

amount in CAD

Total expenses to claim (amount in CAD)*

Upload Receipts

You can upload receipts here or email to osatreasurer3@gmail.com

Upload Receipts

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