Fremont Chinese School - Expense Report P.O. Box 1309, Fremont, CA 94538

(510)438-8866

Serial No.

Payable to :

Department :

Address :

Expense acct : Amount : $

Purpose : Description :

* If the reimbursement is for inventory items, please list the detail quantities. * All receipts should be included.

Item

Receipt

Quantity

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

TOTAL

Amount $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Tax $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

Subtotal $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

-

Requestor Name : English Name

(Last)

(First)

Chinese Name

Requestor Signature :

Date :

/

/

Date :

/

/

/

/

Dept. Head Name : English Name

(Last)

(First)

Chinese Name

Dept. Head Signature : ******** For Accounting Use Only **********************

FCS Acc. # :

Bank Account # :

Date :

Check Issued By :

Check # :

Remark : Check this field, if Accounting Dept. needs to make a copy to Gen. Admin. Dept for inventory record.

Copy of General Expense Form(AC)\ExpnACDept REvised

6/5/2013