RESET FORM
NUMBER LINK
FOREIGN ACCOUNTABLE ADVANCE
RECONCILIATION FORM
(REQUISITION FOR REPORTING OF EXPENSES INCURRED ON UNIVERSITY BUSINESS)
Requistion No.
SEND TO: TRAVEL SERVICES, 405 ADMINISTRATION BLDG.
Employee No.
EXPENSES RELATING TO ACCOUNTABLE ADVANCE #:
T
E
Date:
Reimbursable expenses
Date
Transportation & other
Description
$
Totals 
Hotel/lodging
0.00
$
2
Paid by direct billing or
reimbursed by others
Meals or per diem
$
1
Non-reimbursable expenses
0.00
$
3
0.00
4
0.00
Advance paid to:
$
Total Amount of Advance
Name
Amt of expenses previously reported
$
Amt of expenses in current report
$
Department/Address
Contact Name
Ph Number:
One-over-one name :
Claimant’s
signature:
Total expenses reported to date
$
Balance of advance remaining
$
Signature :
I hereby certify that this is a correct statement of expenses which were
incurred on university business and that all actual or anticipated payments or
FOAP signing authority name :
reimbursements by others have been incorporated
(in compliance with U of M policy #317)
Distribution of reimbursement expenses:
Signature:
Budget Available
as of Claim date
Approved
$
F
O
A
P
A
L
Total $
0.00
Checked By
Initials