HomeMy WebLinkAboutOCDSB 057 Lost Receipt Form
OCDSB 057
LOST RECEIPT FORM
Claimant Name:
EIN:
Department/School:
Date:
This form is to be completed to the best of your ability and attached to a Travel Expense
Claim and/or Cheque Requisition when an invoice, itemized receipt, or other supporting
documentation is misplaced, destroyed, or not received.
Claimants will note the following when submitting a lost receipt form:
• Every effort to attain a receipt, or other documentation to support OCDSB
expenses, should be made;
• This form is not meant to replace obtaining receipts; one form must be filled in for
each lost receipt; and
• For lost air tickets, car rental and hotel receipts, wherever possible, a duplicate
shall be obtained and submitted with this completed form.
This form is submitted in lieu of original receipt and I acknowledge by signing this form that:
• No original receipt for this expense is available;
• The expense was incurred while executing my duties or while on approved District
business; and
• No reimbursement of this expense has been or will be sought or accepted from any
other source.
Description of
Expense:
Date of
Receipt:
Amount:
Vendor:
Vendor
Address:
Claimant
Signature:
Date:
Phone:
Supervisor
Signature:
Date:
Phone: