Reimbursement Request Form

While reimbursement requests can still be submitted in person to the BMC office, we encourage use of this request form to facilitate timely processing. By submitting your request here, submission will be made immediately available to multiple staff members, and subsequent requests for additional documentation are less likely.

Please review the “Know Before You Go” page to help plan your trip to be reimbursable.

Reimbursement Request

This form provides another way to submit your reimbursement requests and related documentation.

Your Name*
Your Email*
Is this reimbursement travel-related?*
- Yes
- No
Location*
City and state, or city and country if international
Description*
Please provide a brief description of your expenses and their purpose. This should include what you paid for versus what was prepaid (e.g. with a lab P-Card). Please include enough detail to allow BMC staff to answer Who, What, Where, When, and Why when preparing your reimbursement.
Business Purpose*
Start Date*
For travel-related requests, this is the departure date. For non-travel requests, this is the date of your earliest expense.
Date Format: MM slash DD slash YYYY
End Date*
For travel-related requests, this is your return date. For non-travel requests, it is the date of your latest expense.
Date Format: MM slash DD slash YYYY
Funding Information*
Please provide the project number(s) (format AAA1111) from which this reimbursement is to be paid. If expenses should be split, please indicate percentages or specific costs next to each project.
Receipt Upload*
Please attach all receipts here. You may scan receipts or take pictures with a smartphone or other device, but please be sure the images are clear.
Drop files here or
Supplementary Forms
If you need to provide additional forms (e.g. you hosted a meal, need to submit a list of event participants, etc.), please upload them here. Several common forms are linked on this page (they can be found at the top of this form on most computers and below the form on mobile devices).
Drop files here or
Prepaid Expenses
If you have any prepaid expenses related to a travel reimbursement (e.g. flights, conference registration), please upload receipts here. Even if reimbursement for these expenses is not requested here, receipts should be included.
Drop files here or
Notes
If you have any other notes you would like to provide on this request, please add them here.

Supplementary Forms (Often Required)

Accountable Plan Exception Request
This form must be submitted with any reimbursement requests older than 90 days. Reimbursements issued outside this period are considered taxable income.
Event Meal Payment Form
If you hosted a meal, please complete and attach this form to your reimbursement request.
Events Refreshment Payment Form
This form should be submitted with requests for reimbursements tied to refreshment breaks during lengthier events.
Participant List
For many events (e.g. hosted meals, receptions, etc.), a list of participants is required with your reimbursement request.

Useful Links

Lodging Maxima and Per Diem Calculator

Vehicle Use/Rental Policy