Professional Development Expense Form - Hamilton Family Health Team

Name

First

Last

Your Email

Today's Date

Your Manager

out wait HST

Manager's Email

Department

Note: You will be reimbursed for your PD expense via Dayforce on an upcoming pay.

PD code: 5320

Expense Date

Description of professional development activity or item:

Total amount (with HST):

HST portion:

Total Amount minus HST (Net Amount)

Are you able to provide a receipt for this expense?

If you are unable to provide a receipt for the expense(s), please provide an explanation of why

Please read the Missing Receipt Declaration below and check the box to acknowledge you have read it.

The Missing Receipt Declaration should be used on rare occasions and may not be used on a routine basis. Please make every effort to contact the vendor/merchant to request a copy of your missing receipt before submitting this form without a receipt. By clicking on the checkbox, you certify that the amount shown is the amount actually paid, and that you will not submit a duplicate claim.

Upload a receipt/invoice (please wait a moment while it uploads)

Click or drag a file to this area to upload.

OPTIONAL- Upload another receipt/invoice for this same PD expense (please fill out another form for a separate expense)

Click or drag a file to this area to upload.

OPTIONAL- Upload another receipt/invoice for this same PD expense (please fill out another form for a separate expense)

Click or drag a file to this area to upload.