Reconciliation Form (Procurement Department)
Reconciliation Form (Procurement Department)
Reconciliation Form (Procurement Department)
Cardholder
Employee ID Billing cycle end date
Reconciler Name
Reconciler Phone
Reconciler Signature
Bank
Proj/Grant (If QR
Transaction Description Bank Transaction No. Vendor Name Dep./Coll. currency Amount
applicable) Amount
Date
I attest that I have not received reimbursement from another source(s) for any expenses claimed. In the event payment is received from another source(s) for any portion of the
expenses claimed, I assume responsibility for reimbursing the University in full for those expenses.