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. You are required to submit this form and complete a requisition in Banner in order for the reimbursement to be processed. See instructions below.

Reimbursement Claim Form

NOTE: YOU MUST DOWNLOAD THE FORM FOR FORMULAS TO WORK CORRECTLY – THEY WILL NOT WORK IN THE BROWSER!

Instructions:

  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. Meals for Guest of State must be itemized separately from state employees, as federal per diem rates do not apply to the 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. A person who works for another state agency, college, or university, is considered a state employee and is NOT a guest of state; therefore, per diem rates will apply.
  5. Special Meeting Forms must be attached to the reimbursement, if applicable.
  6. Create a requisition in Banner and submit a completed Reimbursement Claim Form and all paid, itemized receipts pertaining to the reimbursement, to Procurement Services via the Procurement Documents portal. A description of each item purchased and an explanation of the circumstances requiring the out-of-pocket expenditure must be on the claim form.
  7. The payment is issued from the PO. Once you submit all documentation to Procurement Services they process the PO and send to Accounts Payable for payment. No further action is needed.
  8. 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 procurement@ualr.edu or 501-569-3144.