Form preview

Get the free CLAIM FOR REIMBURSEMENT - usa-federal-formscom

Get Form
U.S. Federal Form sf-1164 CLAIM FOR REIMBURSEMENT FOR EXPENDITURES ON OFFICIAL BUSINESS 1. DEPARTMENT OR ESTABLISHMENT, BUREAU, DIVISION OR OFFICE 2. VOUCHER NUMBER 3. SCHEDULE NUMBER 5. PAID BY Read
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign claim for reimbursement

Edit
Edit your claim for reimbursement 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 claim for reimbursement form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing claim for reimbursement 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
Check your account. If you don't have a profile yet, click Start Free Trial and sign up for one.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit claim for reimbursement. 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.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

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 claim for reimbursement

Illustration

How to Fill Out a Claim for Reimbursement:

01
Gather all necessary documents: Before you start filling out the claim, make sure you have all the relevant documents. This may include receipts, invoices, proof of payment, and any other supporting documentation.
02
Identify the purpose of the reimbursement: Determine what expenses or services you are seeking reimbursement for. Make sure you understand the specific policies and guidelines related to the reimbursement.
03
Provide your personal information: Begin by entering your personal details such as your full name, address, contact information, and employee identification number (if applicable).
04
Include the dates and details: Clearly indicate the dates when the expenses were incurred and provide a concise description of each expense. Be specific and include any relevant information that can support your claim.
05
Attach supporting documents: Scan and attach copies of all the relevant receipts and invoices. Make sure they are legible and clearly indicate the amount and nature of the expense. Keep the originals for your records.
06
Calculate the total reimbursement amount: Sum up all the expenses you are claiming and calculate the total amount you are requesting for reimbursement. Remember to consider any deductible amounts or limits as specified by the reimbursement policy.
07
Sign and date the claim form: Attest your claim by signing and dating the form. This certifies that the information provided is accurate to the best of your knowledge.
08
Submit the claim for reimbursement: Depending on the process established by your organization or insurance company, you may need to submit the claim form electronically, through mail, or via a dedicated online portal. Follow the specified instructions carefully.
09
Follow up, if necessary: Keep track of your claim submission and inquire about its progress if you don't receive a reimbursement within the expected timeframe. Stay proactive and reach out to the appropriate department or contact person to ensure that your claim is being processed.

Who Needs a Claim for Reimbursement?

01
Employees: Individuals who have incurred eligible expenses related to their work or business activities may need to file a claim for reimbursement. This could include travel expenses, business-related purchases, or expenses not covered under the regular compensation package.
02
Insurance policyholders: People with relevant insurance policies, such as health insurance or auto insurance, may need to file a claim for reimbursement of covered expenses. This could include medical bills, prescription medications, or repairs after an accident, depending on the policy terms and conditions.
03
Policyholders with third-party claims: Individuals who have suffered damage or loss due to someone else's actions may need to file a claim for reimbursement against the responsible party's insurance. This can include property damage, personal injury, or liability claims.
Remember to always consult the specific guidelines, policies, and procedures related to your situation before filling out a claim for reimbursement.
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
4.0
Satisfied
59 Votes

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.

By combining pdfFiller with Google Docs, you can generate fillable forms directly in Google Drive. No need to leave Google Drive to make edits or sign documents, including claim for reimbursement. Use pdfFiller's features in Google Drive to handle documents on any internet-connected device.
Yes, you can. With pdfFiller, you not only get a feature-rich PDF editor and fillable form builder but a powerful e-signature solution that you can add directly to your Chrome browser. Using our extension, you can create your legally-binding eSignature by typing, drawing, or capturing a photo of your signature using your webcam. Choose whichever method you prefer and eSign your claim for reimbursement in minutes.
Upload, type, or draw a signature in Gmail with the help of pdfFiller’s add-on. pdfFiller enables you to eSign your claim for reimbursement and other documents right in your inbox. Register your account in order to save signed documents and your personal signatures.
A claim for reimbursement is a request for the payment of expenses incurred by an individual or organization.
The individual or organization that incurred the expenses and is eligible for reimbursement is required to file a claim.
To fill out a claim for reimbursement, one must provide details of the expenses incurred, including receipts or other supporting documentation.
The purpose of a claim for reimbursement is to request the repayment of expenses that were incurred by an individual or organization.
The information that must be reported on a claim for reimbursement includes the date and nature of the expense, the amount spent, and any supporting documentation.
Fill out your claim for reimbursement 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.