Missing Receipt Affidavit

I am a*
- Faculty/Staff
- Student
- Guest
Date of Expense*
MM slash DD slash YYYY
Type of Expense*

Examples: Taxi, meal (specify breakfast, lunch or dinner), parking
Vendor*
Amount*
City of Purchase*

Include state (or country if international)
Business Reason*
By signing below, I certify that I do not have a receipt but this transaction is a valid business related expense, incurred while conducting University business, and reimbursable in accordance with Boston University’s Travel and Business Expense Policy.
Full Name*
BU Email*
Today's Date (MM/DD/YYYY)*