Expense Reimbursement Request Form and Instructions



Used to request reimbursement for out of pocket funds spent on behalf of the University of La Verne or University of La Verne’s various club/organization accounts. Any individual requesting reimbursement must use this form. The form is an interactive form that is located on University of La Verne’s website (under Accounts Payable) and must be completed on line.

Expense Reimbursement Form Policy

The University of La Verne’s Expense Reimbursement Request Form must be used (located at the link above). The form must be fully completed online and then printed out, signed by the payee and approved by the Authorized Approver. All University of La Verne Clubs/Organizations reimbursement requests must be approved by an Officer of the Club in addition to the Club/Organization’s Advisor or Student Affairs Representative. An Accounts Payable signature authorization form, showing all approval signatures, must be on file in Accounts Payable before approving and submitting an Expense Reimbursement Request form to Accounts Payable. The form must be printed on letter size paper, showing the approvals and total amounts on one page.

A Travel Authorization Form (TA) may be required click here for form and instructions. Expenses over 90 days are not reimbursable.

You cannot submit an Expense Reimbursement Request for payment made to an individual. When paying an individual you will need to submit a check request form or a purchase requisition form. The University of La Verne must issue checks directly to individuals and sole proprietors.

Review the Travel Expenditure Policy for reimbursable expenses.


Attach detailed receipts (showing what was purchased) to the Expense Reimbursement Form. Reimbursement requests for meals that do not have detailed receipts will not be paid. The credit card receipts or credit card billing statements are not adequate support for reimbursement. If the receipts for a seminar, membership dues, subscription, etc., do not show the date (s) of the seminar/conference or period covered for dues or subscriptions, you need to attach a form or brochure showing a description and date.

Make sure the form is fully and properly completed online and submitted with original receipts showing proof the expense was incurred and paid for. Occasionally if a receipt is lost and you have to attach a copy please note on the receipt why a copy is being submitted.

Make sure when listing the business purpose of an expense to include the what, where, and why. Ex: for a meeting, you would need to list what type of meeting and the business purpose (why) for the meeting. For mileage reimbursement, you need to list the purpose (what & why) for the mileage and cities of travel (include the starting point and ending point).

List expenses on a daily basis with the exception of an airline ticket and round trip mileage from one place to another. List meals on a daily basis; do not combine the daily totals.


Do not request reimbursement for personal use items, such as:

      1. Greeting cards or gifts for holidays, birthdays, farewells and bereavements for University of La Verne employees or students (past or present)
      2. Kitchen or coffee supplies for the department
      3. Office decorations.

The above list reflects merely examples and is not intended to be all inclusive. If you are unsure about the reimbursement for a potential purchase, please contact Accounts Payable prior to buying the item (s).

Do not submit Expenses that are over 90 days, they are not reimbursable.

Do not submit handwritten or hand typed expense reimbursement forms.

Do not forget to list the business purpose (what, where & why) of the expense.

Form Instructions

Name: Type in the legal name (no nicknames) of the individual being reimbursed.

Payroll or Banner ID: Type in Payroll ID# ( University Employees & Student Workers only) others type in 8-digit Banner ID#.

Address: Type in home address.

Dept: Type in the program/department name.

Phone/Ext: Your phone number and/or extension.

Remit By: If you are a University employee or current or former student worker your reimbursement will be paid through Payroll, (make sure to enter your Payroll ID#). All others should check either U.S. Mail or Intercampus Mail. Accounts Payable mails the checks out directly.

Date: Type in the date the expense was incurred.

Description: Type in a brief detailed description of the business purpose of the expense. If you attended a seminar or conference list the name of the seminar or conference. If you are claiming mileage, list the reason for the mileage, places (cities) of travel. If you attended a meeting, list the name of the meeting and the purpose for the meeting.

Dept/Prog. #: If there is only one program number to be used for all of the expenses you only need to list the 8 digit program number once. If there is more than one program # then you would list the different program numbers to be charged.

Number of Miles: : List the number of miles (daily) for each trip. The system will automatically total the daily miles and multiply it by University of La Verne’s mileage rate. If your mileage will take up more than one expense reimbursement page you should use the Mileage Log Sheet that is located on University of La Verne’s website under Accounts Payable.

Air, Rail, Bus: List amounts for airfare, bus fare, cab fare, car rentals, gas for car rentals, parking and any tips related to these expenses.

Lodging: List the amount for lodging only, including taxes and tips. Do not include parking, meals, phone or internet fees in this field.

Employee Meals: Type in each meal amount in the correct fields: breakfast, lunch or dinner. List the meals on a daily basis. If you are listing a meal for you and other employees due to business travel together, make sure you list the individual’s first and last name and that they are an employee. There is a maximum of $35.00 per day for an individual’s meals.

Phone, Internet & Fax: List phone, Internet or fax expenses in this column.

Misc.: List all other expenses in this column. Miscellaneous expenses include small emergency supplies, printing or postage.

Gross Total: This field will automatically total

Entertainment & Business Meals: List the meals on a daily basis. List the names of the individuals in attendance, company name and title.

Location & Business Purpose: List the location and name of the restaurant and the business purpose (what & why) for the meal.

Amount: This field is automatically totaled and the amount automatically fills in the total entertainment & business box.

Account Distribution Summary: List the expenses (summarized) by the 8-digit program number and 4-digit object code (s). Do not list the expense total on one line if there is more than one program number or object code. Do not list the same program # and object code twice (summarize the totals by program# and object code). The distribution lines will automatically total on the Gross Expenses line. The Gross Expenses must equal the Gross Total. If the two do not agree a warning message will appear. Do not print out the form with the warning message on it and send it to accounts payable. The form will be considered incomplete and will be sent back to the department.

Cash Advance: List any cash advance (1310) or prepaid hotel (1701) that was requested and associated with the expenses on the report. The amount listed will automatically deduct from the Gross Expenses and fill in the Net Expenses total. If there is no cash advance involved, the Gross Expense total will be the Net Expense total. Be sure to turn in any excess funds to Student Accounts and attach the receipt to the Expense Reimbursement Request Form.

Print and Submit Form: Attach the necessary receipts and mileage logs (when used) to the form. Sign the Reimbursement Request, get the proper authorized signature for approval and send the completed form to Accounts Payable. For all Clubs/Organizations an Officer’s approval in addition to the Advisor or Student Affairs Representative’s approval is required. The Expense Reimbursement Form (showing totals and approvals on the same page) must be submitted on letter size paper. The form can be submitted in black and white.

If you have problems with printing the completed form on letter size paper or the form totaling correctly you need to contact the Facilities Technology Services help desk at extension 4130.

Processing/Time Lines

All properly completed and authorized Expense Reimbursement Requests must be submitted to the Accounts Payable Department. The date that the properly completed Expense Reimbursement Request is received in Accounts Payable is the date that is used as the submission date. Reimbursements will be paid through the Payroll Department effective on the March 10, 2009 on your payroll check, (this applies to University Employees and Student Workers). Click here to review the submissions dates and pay dates. Expense Reimbursement Forms for non University Employees need to be received in Accounts Payable by noon on Friday to have a check the following Friday.

Adherence to the above guidelines will enable individuals to be reimbursed in a timely manner. All incomplete and inaccurate forms will be returned to the department for corrections and resubmission. If you have questions regarding completing the form you can contact anyone in Accounts Payable Department at extensions 4116, 4111 or 4112.