Free form template · Word
An expense reimbursement form is the all-purpose claim for small business expenses an employee pays personally, such as client meals, courier charges, stationery, printouts or software subscriptions approved by the manager. Each line carries an expense category and bill reference for accounting.
EXPENSE REIMBURSEMENT CLAIM
| Employee Name | |
|---|---|
| Employee ID | |
| Department | |
| Cost Centre / Project Code | |
| Reporting Manager |
| Date | Category | Vendor | Bill No. | Business Purpose / Attendees | GST (₹) | Amount (₹) |
|---|---|---|---|---|---|---|
| [DD/MM/YYYY] | [C1] | [Vendor] | [Bill No.] | [Client meeting with ...] | [Amount] | [Amount] |
| [DD/MM/YYYY] | [C2] | [Vendor] | [Bill No.] | [Purpose] | [Amount] | [Amount] |
| [DD/MM/YYYY] | [C3] | [Vendor] | [Bill No.] | [Purpose] | [Amount] | [Amount] |
| [DD/MM/YYYY] | [C6] | [Vendor] | [Bill No.] | [Purpose] | [Amount] | [Amount] |
| Total | [Amount] | [Amount] |
For the expense dated [DD/MM/YYYY] of ₹[Amount], the original bill is not available because [Reason]. I confirm the expense was genuinely incurred for official purposes. (Allowed up to ₹[Amount] per claim.)
I certify that these expenses were incurred wholly for the business of [Company Name], that the bills are genuine and have not been claimed before.
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Business expenses you paid personally that your company policy allows, such as client meals, courier, printing or small purchases, supported by bills.
Many companies want a proper invoice. A UPI screenshot may be accepted only with a self-declaration, as policy allows.
Within the deadline set by your policy, commonly within the same month or a set number of days after the expense.