SUNY System Administration

Justification for Reimbursement of Meeting Expenses to a SUNY Employee 
(Breakfast, Lunch or Dinner Meeting)

A Staff Member who paid for meal expenses at a breakfast, lunch or dinner meeting can request 
reimbursement using this form.

Note the following:

1.	A detailed receipt from the restaurant listing all items served must be attached to this form.
2.	Alcoholic beverages do not qualify for reimbursement.


Staff Member Requesting Reimbursement:

	Name:
	Title:									

Meal Information:

	Circle One:	   Breakfast	     Lunch	     Dinner

Meeting Information:

	Name:
	Total # of Attendees:
	Date:			
	Location:																

Provide information about purpose and necessity of the meeting, including specific nature of state business 
conducted (attach meeting agenda if available).  If applicable, explain why the meeting could not be held 
during normal working hours.





Attendees:  Provide information below or attach a separate list

Name:
Title:
Employer:
Relationship to Business Conducted:

Name:
Title:
Employer:
Relationship to Business Conducted:

Name:
Title:
Employer:
Relationship to Business Conducted:

Name:
Title:
Employer:
Relationship to Business Conducted:

						
Supervisor�s Signature: