Form preview

Get the free Reimbursement Request

Get Form
This form is used to request reimbursement for expenses that could not be charged to a ConnectCard, requiring submission of original receipts within 90 days.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign reimbursement request

Edit
Edit your reimbursement request form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your reimbursement request form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing reimbursement request online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
To use our professional PDF editor, follow these steps:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
2
Upload a document. Select Add New on your Dashboard and transfer a file into the system in one of the following ways: by uploading it from your device or importing from the cloud, web, or internal mail. Then, click Start editing.
3
Edit reimbursement request. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Select it in the list of your records. Then, move the cursor to the right toolbar and choose one of the available exporting methods: save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud.
With pdfFiller, it's always easy to deal with documents. Try it right now

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out reimbursement request

Illustration

How to fill out Reimbursement Request

01
Gather all relevant receipts and documentation for the expenses you wish to claim.
02
Obtain a Reimbursement Request form from your employer or organization's finance department.
03
Fill out your personal details, including your name, employee ID, and department.
04
List each expense in the designated section of the form, including the date, amount, and purpose of the expense.
05
Attach copies of all receipts and supporting documents for the expenses listed.
06
Sign and date the form to confirm that the information provided is accurate.
07
Submit the completed form and attachments to your manager or the finance department as per the organization's procedures.

Who needs Reimbursement Request?

01
Employees who incur out-of-pocket expenses related to work activities.
02
Contractors or freelancers who need to get reimbursed for business-related costs.
03
Interns or trainees who spend personal funds on approved company expenses.
04
Members of organizations or clubs when submitting claims for approved expenses.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.6
Satisfied
30 Votes

People Also Ask about

My name is (your name), and I'm contacting you from (where you're from). I'm getting in touch to request reimbursement for (whatever you want reimbursement for). I've provided details here about the specifics of my claim. The expenses were incurred while I was (insert justification for costs).
Ask Openly: Politely ask if they could return it. For example, ``Would you be able to pay me back when you have a chance? I'd really appreciate it.'' Be Flexible: If they are unable to pay you back immediately, consider discussing a timeline that works for both of you.
Sample 4: Letter Requesting Reimbursement The email should include details of the expenses. Dear [Name], I am writing to request reimbursement for the expenses I incurred on behalf of [Company/School/Institution]. I have attached all the receipts and documentation related to the expenses for your reference.
Information to include on an expense reimbursement form. Name of product or service. Individual item or line cost. Total cost. Payment method (i.e., cash, credit card, etc.) Date purchased. Explanation of purchase. Original or copy of the receipt.
We will reimburse all costs. Travel expenses will be reimbursed. reimburse sb for sth Your employer should reimburse you for any expenses incurred. Our company will reimburse you for the full extent of the damage.
Sample 4: Letter Requesting Reimbursement The email should include details of the expenses. Dear [Name], I am writing to request reimbursement for the expenses I incurred on behalf of [Company/School/Institution]. I have attached all the receipts and documentation related to the expenses for your reference.
Reimbursement is when a business pays back an employee, client, or other people for money they spent out of their pocket or for overpaid money. Some examples are getting money back for business costs, insurance premiums, and overpaid taxes.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

A Reimbursement Request is a formal request submitted by an individual or organization to receive reimbursement for expenses incurred during work-related activities or on behalf of the company.
Employees who have incurred out-of-pocket expenses related to their work activities are typically required to file a Reimbursement Request.
To fill out a Reimbursement Request, gather receipts for expenses, complete the required form with detailed information about each expense, including the date, amount, purpose, and attach supporting documentation.
The purpose of a Reimbursement Request is to ensure that individuals are compensated for legitimate work-related expenses and to maintain accurate financial records for the organization.
On a Reimbursement Request, individuals must report information such as the date of the expense, amount spent, purpose of the expense, categories of the expenses, and provide receipts or documentation as proof.
Fill out your reimbursement request online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.