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Reimbursement Request Form
Leave the receipt in the archives office or photograph it and email it separately to the email address below. If unrelated items are on the receipt, circle the relevant ones. Email related documents to
[email protected]
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Name
*
First
Last
Date expense incurred
*
(d/m/y)
Related to (archives, lectures, etc.)
*
Payment for
expense separately incurred
Amount
Receipt will be submitted separately
Submit