Reimbursement Claim Form (Employee Reimbursements Only)

This form allows employees to request reimbursement for expenses that were paid from personal funds and are legal obligations of the university.

Reimbursement Claim Form (pdf fill-in)

Reimbursement Claim Form (print)


  1. This form is for employee reimbursements only.
  2. Mailing address for the employee should exist in Banner. If it does not, employee MUST log into BOSS and add the correct address.
  3. List or identify Guest of State’s meal/amount separately (per diem does not apply to guest).
  4. Reimbursement for meals, including sales tax and up to 15% gratuity cannot exceed the federal per diem rate, as established by the U.S. General Services Administration
  5. Special Meeting Forms must be attached to the reimbursement, if applicable.
  6. Completed forms, with original, itemized receipts attached, should be forwarded to Procurement Services.
  7. To speed up your reimbursement, set up direct deposit by completing the Authorization for Direct Deposit of Non-Payroll Reimbursements.

For assistance with this form, please contact Procurement Services at 501.569.3144.