Templates Business Operations Employment Simple Reimbursement Form Template

Simple Reimbursement Form Template

Use This Template
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Requestor Information

Full Name

Reimbursement Details

Item/Service

Description

Actual Cost

$0.00

Approval Section

The Simple Reimbursement Form Template by WPForms is the perfect solution for streamlining reimbursement submissions.

How Does the Simple Reimbursement Form Template Work?

To fully utilize the Simple Reimbursement Form Template, you’ll require the WPForms Pro License, the Save and Resume, and Signature Addons.

The Save and Resume Addon allows the requestor to enter all reimbursement information and then share the form with the approver.

Meanwhile, the Signature Addon allows both the requestor and approver to provide their digital signatures to authenticate the reimbursement request.

Fields Included in the Simple Reimbursement Form Template

  • Requestor Information:
    • Full Name: The requester’s complete name for identification.
    • Department: Where the requester is positioned within the organization.
    • Position: The requester’s job title for record-keeping purposes.
    • Contact Number: A direct line to the requester for any clarifications.
    • Email Address: This is to send confirmations of the submitted requests.
  • Reimbursement Details:
    • Purpose of Reimbursement: The reason behind the expenditure.
    • Item/Service, Description, Actual Cost: Details of expenses incurred.
    • Total Expenses: An auto-calculated sum of the costs entered above.
    • Requestor’s Signature: A digital signature from the requester.
    • Date of Request: When the form was filled out and submitted.
  • Approval Section:
    • Full Name: The person responsible for reviewing and approving.
    • Position: The approver’s job title within the organization.
    • Phone: Contact details of the approver in case of emergencies.
    • Email: Send approval notifications or request additional information.
    • Comments: Space for the approver to include any notes regarding the request.
    • Signature and Date: A digital signature from the approver and the approval date.

Sign up with WPForms today and access the Simple Reimbursement Form Template to manage reimbursements in small to large organizations.