University of Colorado - ECEE Department

Date MM / DD / YYYY
Are you a current CU employee?
Full Name *

Please enter your full name.
Speedtype *
Maximum of 8 digits. Currently Used: 0 digits.

Please enter a speedtype.
Speedtype
Maximum of 8 digits. Currently Used: 0 digits.

Please enter an additional speedtype if applicable.
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please fill in your address.
Email *

Please fill in your email address.
Attach Itemized Reimbursable Receipts (.zip file)

Please attach receipts for which you would like to be reimbursed. If possible, combine receipt images into a zip file.
Please check one the following: *
I am a US Citizen/Permanent Resident I am not a US Citizen/Permanent Resident
Travel or Expense Reimbursement? *

Please choose "Travel" if turning in receipts for travel. Please choose "Reimbursable Expenses" for all others (ie. equipment, group meals, lab supplies, ect.).
Travel Reimbursement Information

Please enter the travel information below.
Start of Travel * MM / DD / YYYY
Please enter the date which you started travel.
End of Travel * MM / DD / YYYY
Please enter the end date of your travel.
Destination City / Location
Per Diem Requested
Yes

Leave Blank if no per diem is requested.
Items to be Reimbursed *

Please enter all expenses you would like to be reimbursed for. If its easier, please attach a summary (excel, word, etc) in the next file attached field.
Attach travel summary page if applicable (excel, word, PDF).

Please attach a list / spreadsheet of all item that you would like to be reimbursed for. Please include your reason for travel.
Equipment and Supplies Reimbursement Information

Please fill out the following information if you are requesting reimbursement for lab or project expenses.
Fabrication Tag Number

If you know what a tag number is and it is applicable please enter here. Otherwise, this field can be ignored.
Please list expenses you would like to be reimbursed for:

If you are requesting a reimbursement for an official function (meals) with 10 of fewer people, please list all attendees.
Attach equipment summary page if applicable (excel, word, PDF).

Please attach a list / spreadsheet of all item that you would like to be reimbursed for. Please include a justification for your purchases.
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University of Colorado - ECEE Department

Travel Reimbursement Information

Equipment and Supplies Reimbursement Information