Note: This document is intended only as a sample to illustrate the information that should be contained in a declaration when original receipts or copies are lost, accidentally destroyed or unobtainable.
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SAMPLE LOST OR DESTROYED RECEIPT DECLARATION |
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Declaration by Claimant - To be used in lieu of unavailable receipt |
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I, |
hereby |
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declare that I have paid for the following goods or services incurred by me on travel for government business and that the invoice was: |
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Lost |
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Destroyed |
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Inadvertently not obtained |
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Other (specify): |
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Invoice detail:
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Date |
Person / Business |
Amount |
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$ |
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GST/HST |
$ |
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TOTAL |
$ |
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Description of Goods or Services provided: |
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Signature of Claimant |