Reimbursement Requisition Form RHG-JF-401

Reimbursement Requisition Form

RHG-JF-401| Version 1 | Review 08/08/2025
Name*

First NameLast Name
Employee Email*
Approval status will be emailed once processed by your manager
Entity
Receipt Date*

DayMonthYear
Purchase Description*
Does the receipt relate to a job?*

YesNo
Business Unit
Job Code
Enter Job Number
Item Code
PLEASE NOTE: Meals or entertainment related to a job
PLEASE NOTE: Staff only i.e office functions, staff meals/entertainment at restaurants
PLEASE NOTE: No entertainment- purely to provide a meal as you are away from your home
Attendees

StaffClientsAssociates
Number of Staff
Number of Clients
Number of Associates
Associates/partners
Meal Type

BreakfastLunchDinnerCoffee/Drinks
Where (Supplier Name)
Client Name
Receipt Amount*
Attach Receipt

Upload a File

Cancelof
Back Charge to Client

YESNO
ADD MORE REIMBURSEMENTS?

YESNO
- Receipt Date (2)*
  
  DayMonthYear
- Purchase Description (2)*
- Does the receipt relate to a job? (2)*
  
  YesNo
- Business Unit (2)
- Job Code (2)
- Enter Job Number (2)
- Item Code (2)
- PLEASE NOTE: Meals or entertainment related to a job (2)
- PLEASE NOTE: Includes Client or Associates (2)
- PLEASE NOTE: Staff only i.e office functions, staff meals/entertainment at restaurants (2)
- PLEASE NOTE: No entertainment- purely to provide a meal as you are away from your home (2)
- Attendees (2)
  
  StaffClientsAssociates
- Number of Staff (2)
- Number of Clients (2)
- Number of Associates (2)
  Associates/partners
- Meal Type (2)
  
  BreakfastLunchDinnerCoffee/Drinks
- Where (Supplier Name) (2)
- Client Name (2)
- Receipt Amount (2)*
- Attach Receipt (2)
  
  Upload a File
  
  Cancelof
- Back Charge to Client (2)
  
  YESNO
- ADD MORE REIMBURSEMENTS? (2)
  
  YESNO
- Receipt Date (3)*
  
  DayMonthYear
- Purchase Description (3)*
- Does the receipt relate to a job? (3)*
  
  YesNo
- Business Unit (3)
- Job Code (3)
- Enter Job Number (3)
- Item Code (3)
- PLEASE NOTE: Meals or entertainment related to a job (3)
- PLEASE NOTE: Includes Client or Associates (3)
- PLEASE NOTE: Staff only i.e office functions, staff meals/entertainment at restaurants (3)
- PLEASE NOTE: No entertainment- purely to provide a meal as you are away from your home (3)
- Attendees (3)
  
  StaffClientsAssociates
- Number of Staff (3)
- Number of Clients (3)
- Number of Associates (3)
  Associates/partners
- Meal Type (3)
  
  BreakfastLunchDinnerCoffee/Drinks
- Where (Supplier Name) (3)
- Client Name (3)
- Receipt Amount (3)*
- Attach Receipt (3)
  
  Upload a File
  
  Cancelof
- Back Charge to Client (3)
  
  YESNO
- ADD MORE REIMBURSEMENTS? (3)
  
  YESNO
- Receipt Date (4)*
  
  DayMonthYear
- Purchase Description (4)*
- Does the receipt relate to a job? (4)*
  
  YesNo
- Business Unit (4)
- Job Code (4)
- Enter Job Number (4)
- Item Code (4)
- PLEASE NOTE: Meals or entertainment related to a job (4)
- PLEASE NOTE: Includes Client or Associates (4)
- PLEASE NOTE: Staff only i.e office functions, staff meals/entertainment at restaurants (4)
- PLEASE NOTE: No entertainment- purely to provide a meal as you are away from your home (4)
- Attendees (4)
  
  StaffClientsAssociates
- Number of Staff (4)
- Number of Clients (4)
- Number of Associates (4)
  Associates/partners
- Meal Type (4)
  
  BreakfastLunchDinnerCoffee/Drinks
- Where (Supplier Name) (4)
- Client Name (4)
- Receipt Amount (4)*
- Attach Receipt (4)
  
  Upload a File
  
  Cancelof
- Back Charge to Client (4)
  
  YESNO
- ADD MORE REIMBURSEMENTS? (4)
  
  YESNO
- Receipt Date (5)*
  
  DayMonthYear
- Purchase Description (5)*
- Does the receipt relate to a job? (5)*
  
  YesNo
- Business Unit (5)
- Job Code (5)
- Enter Job Number (5)
- Item Code (5)
- PLEASE NOTE: Meals or entertainment related to a job (5)
- PLEASE NOTE: Includes Client or Associates (5)
- PLEASE NOTE: Staff only i.e office functions, staff meals/entertainment at restaurants (5)
- PLEASE NOTE: No entertainment- purely to provide a meal as you are away from your home (5)
- Attendees (5)
  
  StaffClientsAssociates
- Number of Staff (5)
- Number of Clients (5)
- Number of Associates (5)
  Associates/partners
- Meal Type (5)
  
  BreakfastLunchDinnerCoffee/Drinks
- Where (Supplier Name) (5)
- Client Name (5)
- Receipt Amount (5)*
- Attach Receipt (5)
  
  Upload a File
  
  Cancelof
- Back Charge to Client (5)
  
  YESNO
- ADD MORE REIMBURSEMENTS? (5)
  
  YESNO
- This claim form only allows up to 5 submissions. Please submit this form and start a new one for additional claims required.
- Your Manager/Supervisor*
- Approving Manager
- Approved
  
  YesNoPartly
- Comments
- Reimbursement Complete
  
  YesNo
- PLEASE NOTE: Includes Client or Associates.
- Should be Empty: