
This box will calculate your
Total Receipts Under $75
BUSINESS PURPOSE
UNIVERSAL EXPENSE FORM
Note: Receipts must be received by the TRO within 60 days of the date expense incurred.
EMPLOYEE TYPE OR AFFILIATION
PAYMENT TYPE
(CHECK ALL THAT APPLY)
Harvard Employee
Affiliate/Harvard Student/Casual/Stipend- Complete Non-Employee Section
Invited Guest/Visitor - Complete Non-Employee Section
Reimbursement Method
Date:
Harvard ID#:
Reimbursee or Cardholder Name:
Web Voucher/PO#:
US Citizen or Permanent Resident: Yes No
Permanent Residents - Resident Alien Card # _____________
If you are not a US Citizen or Permanent Resident, provide:
Visa Type: Country of Tax Residency:
(Detailed reason for expenditure. For travel or entertainment, include person and/or organization visited and location.
Alsoinclude expense date range. List additional business purposes on page 2.)
Date(s) of expense(s)
#1
#2
#3
#4
#5
SUMMARY OF EXPENSES
(Room for additional expenses is available on page 2)
Business
Purpose#
Description (date, detail, etc.)
Air/Rail
Travel
Ground
Trans.
Lodging
Business
Meals
Other
Total
Subtotals from page 2, if applicable:
REPORT TOTAL :
REIMBURSEE: I certify that these are all legitimate Harvard University business expenses. By signing this form you agree
that no unallowable costs, including undocumented expenses under $75 are being charged to federal grants
SIGNATURE:
Date:
Reimbursee Permanent Legal Address:
Reimbursee Check Mailing Address, if different than Legal:
P
reparer: __________________________________ Phone: ___________ Approver: ___________________________________
(PRINT) (SIGNATURE)
1
LESS ADVANCES EXPENSE:
Out of Pocket
Corporate Card
Direct Deposit
Paper Check