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Reimbursement Form
Please complete the required info for IGC to process the reimbursement. Ensure the receipt upload contains vendor name, date, total matching your reimbursement amount. Submit a new form if more than 5 vendors.
Your Information
Name
*
Address
*
Email
*
Expense Details
Vendor #1
Date of Expense #1
Amount #1
Description of Expense #1
Receipt #1
Click to choose a file or drag here
Size limit: 10 MB
Vendor #2
Date of Expense #2
Amount #2
Description of Expense #2
Receipt #2
Click to choose a file or drag here
Size limit: 10 MB
Vendor #3
Date of Expense #3
Amount #3
Description of Expense #3
Receipt #3
Click to choose a file or drag here
Size limit: 10 MB
Vendor #4
Date of Expense #4
Amount #4
Description of Expense #4
Receipt #4
Click to choose a file or drag here
Size limit: 10 MB
Vendor #5
Date of Expense #5
Amount #5
Description of Expense #5
Receipt #5
Click to choose a file or drag here
Size limit: 10 MB
Total Reimbursement Amount is
$
Additional Comments for Finance Team
Signature
*
Signature
Submit for Approval
