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Employee reimbursement form 2026

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The document is the State of Arizona Employee Expense Reimbursement Form, designed for employees to record and claim reimbursement for expenses incurred on behalf of the State, excluding travel-related costs. It outlines the necessary information required from both the claimant and their supervisor/manager, including signatures and total amounts claimed. The form emphasizes that receipts must be attached and provides detailed instructions on its proper use, ensuring compliance with state policies.

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Click ‘Get Form’ to open the employee reimbursement form in the editor.
Begin by filling out the 'Claimant and Claimant’s Supervisor/Manager' section. Enter your name, EIN, and signature along with the date of signing. Ensure that all fields are completed accurately.
In the 'Amount Incurred' section, list each expense along with the corresponding 'Date Incurred' and a brief 'Description' of each expense. Make sure to total these amounts correctly.
Next, move to the 'For Agency Approval and Payroll Entry' section. Here, ensure that the total matches the amount listed above. Fill in all required fields including Pay Code, PPE Incurred Date, and Accounting Unit.
Attach all necessary receipts as originals or true copies to support your claims before submitting the form for approval.

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