APPENDIX B
   TRAVEL, MEAL, AND LODGING EXPENSE REIMBURSEMENT FORM
Name of Official or Employee:
 
 
Title/Position of Official or Employee:
 
 
Name and Date of the Activity/Event:
 
 
Check Number:
(if applicable)
 
Credit Card Receipt Number:
(if applicable)
 
Description of the purpose of the expense:
 
 
   Reimbursement Expense
   (estimated costs or actual costs with receipts, if applicable)
Mileage:
 
 
Meals:
 
 
Parking:
 
 
Hotel/Lodging:
 
 
Car:
 
 
Airfare:
 
 
Other Transportation:
(bus, train, taxi, shuttle, etc.)
 
Employee’s/Officer’s Signature and Date:
 
 
Village Authorization and Date:
 
 
 
(Ord. 89-09, passed 4-12-89; Am. Ord. 2017-004, passed 4-19-17)