Get Harvard University Application Form

Preparer Phone Approver PRINT HARVARD UNIVERSITY UNIVERSAL EXPENSE FORM SUPPLEMENTAL INFORMATION PAGE OF Departmental Accounting The area below is for departments whose financial office requires this information for processing purposes. UNIVERSAL EXPENSE FORM Note Receipts must be received by the TRO within 60 days of the date expense incurred. EMPLOYEE TYPE OR AFFILIATION PAYMENT TYPE CHECK ALL THAT APPLY Affiliate/Harvard Student/Casual/Stipend- Complete Non-Employee Section Out of Pocket GE Capital Corporate Card Invited Guest/Visitor Complete Non-Employee Section Reimbursement Method Harvard Employee Direct Deposit Paper Check Date Harvard ID Reimbursee or Cardholder Name Non-Employees Complete This Section. Social Sec/Tax ID BUSINESS PURPOSE Web Voucher/PO US Citizen or Permanent Resident Yes No Permanent Residents - Resident Alien Card If you are not a US Citizen or Permanent Resident provide Visa Type Country of Tax Residency Detailed reason for expenditure. For travel or entertainment include person and/or organization visited and location. Also include expense date range. List additional business purposes on page 2. Date s of expense s To Participate in Values in Global Health conference held at Harvard University May 24-26 2007 organized by Prof. Arthur Kleinman Harvard University Prof. Gerald Keusch Boston University and Prof. Kearsly Stewart Northwestern University SUMMARY OF EXPENSES Room for additional expenses is available on page 2 Description date detail etc Business Purpose Air/Rail Travel Ground Trans. Lodging Meals Other Total Subtotals from page 2 if applicable LESS ADVANCES EXPENSE REPORT TOTAL TOTAL AMOUNT OF RECEIPTS UNDER 75 REIMBURSEE I certify that these are all legitimate Harvard University business expenses. List additional business purposes on page 2. Date s of expense s To Participate in Values in Global Health conference held at Harvard University May 24-26 2007 organized by Prof. Arthur Kleinman Harvard University Prof. Gerald Keusch Boston University and Prof. Kearsly Stewart Northwestern University SUMMARY OF EXPENSES Room for additional expenses is available on page 2 Description date detail etc Business Purpose Air/Rail Travel Ground Trans. Lodging Meals Other Total Subtotals from page 2 if applicable LESS ADVANCES EXPENSE REPORT TOTAL TOTAL AMOUNT OF RECEIPTS UNDER 75 REIMBURSEE I certify that these are all legitimate Harvard University business expenses. By signing this form you agree that no unallowable costs including undocumented expenses under 75 are being charged to federal grants SIGNATURE Reimbursee Permanent Legal Address Reimbursee Check Mailing Address if different than Legal. UNIVERSAL EXPENSE FORM Note Receipts must be received by the TRO within 60 days of the date expense incurred* EMPLOYEE TYPE OR AFFILIATION PAYMENT TYPE CHECK ALL THAT APPLY Affiliate/Harvard Student/Casual/Stipend- Complete Non-Employee Section Out of Pocket GE Capital Corporate Card Invited Guest/Visitor Complete Non-Employee Section Reimbursement Method Harvard Employee Direct Deposit Paper Check Date Harvard ID Reimbursee or Cardholder Name Non-Employees Complete This Section* Social Sec/Tax ID BUSINESS PURPOSE Web Voucher/PO US Citizen or Permanent Resident Yes No Permanent Residents - Resident Alien Card If you are not a US Citizen or Permanent Resident provide Visa Type Country of Tax Residency Detailed reason for expenditure. .