APPM Expense Reimbursement Form (Non Travel & Non-Pcard)

Please submit this form in order to receive a reimbursement for expenses that you've incurred that are related to your research or teaching. ��Please fill out one form per purchase.

Important Procurement Information

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APPM Software Purchase Process

Indicates required field

Contact Information

Name

Date of purchase

Vendor

Total Amount

Speedtype Number or Fund Description

Split Charge Between Multiple Speedtypes?

��Yes

��No

Splits

Split 1

Split 2

Split 3

For each split please provide a speedtype number and $ amount.

Items purchased

Business Purpose

Is this for an IT Hardware or Software purchase

��Yes

��No

��Please work with am_itsup@colorado.edu to make sure this is allowable

Was Food Purchased?

��Yes

��No

Purchased Food

List of Attendees

If under 10 attendees, please include the names of the attendees.�� If over 10 attendees, please indicate the total number of people per category (e.g. 15 faculty, 20 students).

Itemized Receipt

Unlimited number of files can be uploaded to this field.
100 MB limit.
Allowed types: doc docx jpg jpeg pdf png xls xlsx.

Confirm

��I confirm that funds are available for this charge.

funds available for this charge

��I understand that tips over 20% will not be reimbursed

��I would like a copy of this form emailed to me.

Would You Like a Copy of This form emailed to You?

Ģ��Ӱ��

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APPM Expense Reimbursement Form (Non Travel & Non-Pcard)

Important Procurement Information