LIDS Reimbursement Reporting Form  Admin: Shyla
FOR USE BY: Students/Postdocs/Visitors supported by, Bresler, Ozdaglar, Shah, and Wilson.  

This form will ask for:
1. the purpose of your reimbursement
2. the details of the purchase

Please EMAIL legible PDFs of receipts (for which you are submitting this form) to Shyla (putrevu@mit.edu). The receipt must be an itemized one, showing the date, merchant, and total amount paid.

You will receive an email receipt of this submission as well as a link to edit; use the link to edit responses as opposed to submitting a new response for the same reimbursement. 

If you have any problems or need assistance, please feel free to email me at putrevu@mit.edu
 
Thank you!
Shyla
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First Name and Last Name of Purchaser *
Purchaser Type *
Grad student, postdoc, visitor (please include the name of host institution), etc.
Research Advisor's Name *
Receipt #1 -- Date *
Receipt #1 -- Amount *
Receipt #1 -- Explanation *
If Meal -- give Agenda/Topic of Discussion.  If Other -- describe item & reason for purchase.
Receipt #1 -- iif it is for food, please list Attendees (Names and Affiliations) *
If MIT, note Postdoc, Grad, Visiting Student, Visiting Researcher, etc.
Receipt #2 -- Date
Receipt #2 -- Amount
Receipt #2 -- Explanation
If Meal -- give Agenda/Topic of Discussion.  If Other -- describe item & reason for purchase.
Receipt #2 -- if it is for food, please list Attendees (Names and Affiliations)
If MIT, note Postdoc, Grad, Visiting Student, Visiting Researcher, etc.
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