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This form is to be completed when the original receipt has been lost or destroyed and only where a replacement con not be obtained.

Lost receipt declaration form template. The form of payment I used check one. CERTIFICATION OF MISSING OR LOST RECEIPT NOTE. For any expenditure that is not supported by a tax invoice or receipt attempts should be made to contact the issuing vendor to acquire such documents to substantiate claims.

Claim or transactions will not be approved without being supported by declaration form. Supervisor Budget Head Signature. A missing receipt form is filled up and used by a person to request the higher authorities or management to issue him a secondary receipt when he may have misplaced or lost the original.

Such information includes the companys name office and store address and contact details. SupervisorBudget Head Print Name. LOST RECEIPT DECLARATION FORM LOST RECEIPT The claimant is required to use best endeavours to obtain duplicate receipts such as contacting supplier.

Therefore I am authorizing payment of the receipt or invoice in light of the circumstances involved. Duplicate copies of receipts are usually readily available from hotels airlines and vehicle rental agencies. I understand that a Missing Receipt Declaration may not be completed on a routine basis and that overuse may revoke the privilege of providing a Declaration in lieu of a receipt.

This form is to be completed when the original tax invoice receipt has been lost or is unobtainable. This Lost Receipt Form template contains form fields that ask for the date of purchase payment method used type of expense name of the vendor branch or location of the vendor customers name customers contact details purchased items and the total amount. Lost Credit Card Receipt.

I certify that the amount shown is the amount. The Missing Receipt Affidavit should be used when the merchant has not provided a receipt or a duplicate receipt cannot be obtained. B Please complete this form online and print for signing The Expenditure Declaration Form should only be used in instances where a receipt or tax invoice is not available to substantiate expenditure claims.

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