This expense statement document contains fields for an employee's name, ID number, social security number, position, department, manager, and pay period dates. It includes columns to track expenses for lodging, transportation, fuel, meals, phone, entertainment, other, and totals for the pay period. At the bottom are areas to note the subtotal, any advances, total amount, approval, and notes.

1. Statement No.
Expense Statement
Employee Pay Period
Name Emp # From
SSN Position
Department Manager To
Date Account Description Lodging Transport Fuel Meals Phone Entertainment Other TOTAL
Sub Total
Approved Notes Advances
TOTAL
Office Use Only
Insert Fine Print Here