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["EMPLOYEE EXPENSE WORKSHEET"]
["Complete this worksheet and submit with related receipts to the preparer for entry.  Use for all employee travel and non-travel reimbursements.  "]
["After entry and approval the PeopleSoft barcoded Expense Report, this worksheet with receipts attached, "]
["is sent to Imaging.",{"$nulls":10},"Expense Report Number",{"$nulls":4},"IGNORE"]
["Employee ID","IGNORE THIS LINE",{"$nulls":9},"Authorization ID Number",{"$nulls":4},"IGNORE"]
["Name",{"$nulls":10},"Advance ID Number",{"$nulls":4},"IGNORE"]
["Address",{"$nulls":10},"Travel Destination(s)/Purchase Location(s)",{"$nulls":4},"Berkeley, California"]
["City/State/Zip",{"$nulls":10},"Travel/Purchase Date(s) MM/DD/YY:",null,null,null,"From:",{"$nulls":5},"To:"]
["Frequent Flyer Miles Earned (Optional)",null,"IGNORE",{"$nulls":8},"Travel Times (AM/PM):",null,null,null,"Depart:",{"$nulls":5},"Return:"]
["Frequent Flyer Miles Used (Optional)",null,"IGNORE",{"$nulls":8},"Foreign Conversion Rate"]
[]
["Detailed Expense Justification (Who, What, Where, Why & When): Attach additional sheet when necessary."]
[]
[]
[]
[]
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["Totals:",null,null,0,null,0,0,null,0,null,0,{"$nulls":4},0,0,{"$nulls":4},0,null,null,0]
["My Signature Certifies:\n• The listed expenses are legitimate.\n• I have not been nor will I be reimbursed for these expenses by any other source(s).\n• I have not earned frequent flyer points for personal use.\n• Required receipts/documentation are attached.",{"$nulls":5},"Helpful Links:",{"$nulls":8},"Additional Page(s) Total:",{"$nulls":8},0]
[{"$nulls":5}," ","http://www.gsa.gov/Portal/gsa/ep/contentView.do?contentId=17943&contentType=GSA_BASIC",{"$nulls":8},"Total Amount to be Reimbursed:",{"$nulls":8},0]
[]
[{"$nulls":15},"Prepaid Expenses",null,null,"Document #",{"$nulls":5},"Amount"]
[{"$nulls":5}," ","http://www.gsa.gov/Portal/gsa/ep/contentView.do?programId=9704&channelId=-15943&ooid=16365&contentId=16177&pageTypeId=8203&contentType=GSA_BASIC&programPage=%2Fep%2Fprogram%2FgsaBasic.jsp&P=MTT",{"$nulls":8},"Airfare:",null,null,"IGNORE",{"$nulls":5},0]
[{"$nulls":15},"Conf. Registration:",null,null,"IGNORE",{"$nulls":5},0]
[{"$nulls":15},"Other:",null,null,"IGNORE",{"$nulls":5},0]
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[]
["Signature of Payee & Date",null,null,"Fund","DeptID","Program","PCBU",null,"Project",null,"A","FIN EMPLID",null,"Account",null,"CF1",null,null,"CF2",{"$nulls":4},"CS","Amount"]
[null,null,null,"3002","11140",null,null,null,"00012903",null,null,"N/A",null,"720607"]
[]
["Optional Authorized Signature & Date"]

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["EMPLOYEE EXPENSE WORKSHEET OPTIONAL PAGE 1"]
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["EMPLOYEE EXPENSE WORKSHEET OPTIONAL PAGE 2"]
[]
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["EMPLOYEE EXPENSE WORKSHEET OPTIONAL PAGE 3"]
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