Expense Account
Employee Name:
Employee ID:
Department:
Expenses From (date):
Expenses To (date):
SLB Internet Business Solutions
PO Box 131385
Springfield, IL
Any Country
62791-3185
Phone: 111-222-3333
Fax: 111-222-4444
http://www.slbibs.com
Expense Date
Expense Description
Cost Center
Expense Amount
Total Expenses
Total Advance
Total Reimbursement
Comments:
Signature:
Authorized By:
Date:
Internal Use Only
Amount Paid
Check No.
Date