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NORTH CAROLINA AGENCY

By Alicia Watkins,2014-05-17 07:31
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NORTH CAROLINA AGENCY

    UNC CHARLOTTE

    MISSING RECEIPT AFFIDAVIT

Please read the Missing Receipt Affidavit requirements on the back of this form. Missing Receipt

    Affidavits lacking the required information or documentation will be returned to the authorized signer.

    Airline Ticket Receipts

    ? Attached is a copy or fax of the airline ticket receipt (last page of the ticket stub). -OR- I certify that I have contacted the agency and was unable to obtain a copy of the ticket receipt.

    Therefore I have attached the following:

    ? A copy of the itinerary invoice and form of payment (i.e., credit card statement, cancelled check)

    Hotel Folio

    ? Attached is a copy or fax of the hotel folio.

    -OR- I certify that I have contacted the hotel and was unable to obtain a copy of the hotel folio. Please reimburse me based on the following information (attach payment verification):

    Dates Hotel/City # of Nights Daily Rate* Total

    __________ ____________________________ _________ __________ ___________

    __________ ____________________________ _________ __________ ___________ *Daily rate excluding taxes and service charges

    Car Rental Agreement

    ? Attached is a copy or fax of the car rental agreement.

    -OR- I certify that I have contacted the rental car agency and was unable to obtain a copy of the car rental agreement. Please reimburse me based on the following information (attach payment verification):

    Dates Rental Company Car Class* # of Days Total

    __________ ____________________________ _________ __________ ___________ *C=Compact, M=Mid-size, F=Full-size

    Miscellaneous

    ? Attached is a copy of the credit card statement, cancelled check, or other documentary evidence. Date Description (in detail) Total __________ ________________________________________________________ ___________ __________ ________________________________________________________ ___________

     I, the undersigned, certify

    (a) that each expense described above, reported on attached reimbursement request dated

    _____________ was lost or not obtained, and

     (b) that these expenses have not yet nor will again be submitted to this or any other organization

    for reimbursement or tax purposes.

    Employees will be responsible for payment of all tax penalties and organization expenses related to their

    lack of original receipts.

    Signature of Payee ______________________________________________ Date ________

     REQUIRED

    Supervisor’s Signature ____________________________________________ Date ________

     REQUIRED

    DOCUMENTATION REQUIREMENTS

UNC Charlotte requires individuals to submit the following documentation to substantiate all expenses

    other than subsistence.

    ? Air/Rail original ticket receipt ? Hotel hotel folio is required for all lodging expenses, regardless of cost. ? Car Rental original car rental agreement receipt

    ? Personal Car Usage receipts for tolls and parking and daily mileage log listing date, itinerary, and

    number of miles.

    ? Meals/Entertainment cash register receipt and proof of payment (does not apply to travel

    subsistence)

    ? Receipts must include the name of the vendor, location, date, and dollar amount. ? Detailed cash or sales receipts

    ? Packing slips with a dollar amount

    ? Subscription or dues forms

    MISSING RECEIPTS

    General

    Individuals must attempt to obtain a copy of the original receipt from the vendor for all travel costs.

    Missing receipt affidavits must be signed by both the individual and authorized signer with a complete

    explanation of the expense if a copy of the receipt is unobtainable.

    Airline Ticket

    In the event of a missing airline receipt (last page of the ticket stub), boarding passes or other original

    document, the affidavit must be accompanied by some form of documentation that substantiates the

    payment. The travel agency issuing the original ticket must be contacted and a copy of the receipt

    requested. All travel agencies are required by the Airline Reporting Commission to keep copies of every

    ticket they issue.

    If the traveler is unable to obtain a copy of the airline receipt, acceptable alternatives are a copy of the

    airline or agency itinerary showing form of payment, a credit card statement, or a cancelled check. One

    of these must be included with the missing receipt affidavit.

    Hotel Folio

    The IRS Accountable Plan requires a hotel folio or itemized bill for all lodging reimbursements. In the

    event of a missing original paid receipt, a copy of the online booking or other documentation with proof

    of payment is required with the missing receipt affidavit.

    For complete information on expense reporting, please refer to the UNC Charlotte Travel Procedure

    Manual.

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