Certification & Electronic Signature
I certify that: (1) all expenses listed were incurred by me in the conduct of legitimate business for the entity selected above and are accurately described; (2) all information is true and complete; (3) personal expenses have not been previously reimbursed and will not be claimed as personal tax deductions; (4) company card charges were incurred solely for business purposes; (5) receipts are attached to each applicable expense item as required by IRS regulations (IRC §274, Pub. 463); (6) meal attendee information has been provided for all meals exceeding $75 per person as required by law.
Submitting false or fraudulent claims may result in termination, mandatory repayment, and referral for legal prosecution under applicable federal and state law.
I confirm that all information in this form is accurate and complete, and I agree to the certification statement above.
You must confirm before submitting.