Expense Request

EXPENSE REQUEST
Person Making Application
Requesting email
example@example.com
Type of Payment*
Payable to

Wages AccountOther Bank AccountCredit Card
Have you already paid?

YesNo
Card*
Purchase Date

DayMonthYear
Payment Date

DayMonthYear
Leave blank for next available payment day
Exempt Benefits*
All Receipts attached*

YesNo
Phone Allowance
Phone Bill attached*

YesNo
Pastoral Care Meetings
Receipts must be attached*

Yes
Please include link to payment page
Payee Name
Company or person payment is being made to
Pay to
Department or Budget Line receiving funds
Payment Method
Have we paid this account/card before?

YesNo
Payee ABN
BPAY Details*
Bank Details*
Account Details*
Card ending
Card Details*
Claim Tally Spreadsheet Upload

Please upload as excel spreadsheet
Cancelof
Bank Statement Upload

Please highlight relevant transactions
Cancelof
Purchases*
Please include initials of Book Allowance/Exempt Benefits in Description
Please include location/contact for LOS grant in Description
Total
Total GST
Additional Notes/Comments
Invoices/Receipts Upload

Cancelof
Please make sure the photo includes the ABN and GST amount
Does your statements show amounts including cash out?*

YesNo
Approver (Department Head)*

Myself/Approval attached in fileSomeone else
Signature

Clear
Approver email
example@example.com
Should be Empty: