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Missing Receipt Affidavit
Date of Receipt
(Required)
MM slash DD slash YYYY
Employee Name
(Required)
First
Last
Employee Email Address
(Required)
Vendor Name:
(Required)
Vendor Address:
Description of Goods/Services:
(Required)
Customer/Job
(Required)
Total Amount:
(Required)
Reason for not getting a receipt:
(Required)
Agreement Terms: I affirm that the above referenced purchase was a valid business related expense and that the receipt was lost. I agree that if the above purchase is determined to have NOT been a valid business related expense that the full purchase amount will be deducted form my earnings during the next pay period after discovery.
Signature