COBRAS Expense Form
- If you are to be reimbursed, please be sure your email and address information on the form is correct. Normally, reimbursements are made via a bank bill pay check and will be mailed to the address listed on this form.
- For each item, please indicate the vendor, expense category and the amount.
- Please scan or photograph the receipt and upload the file to the form.
- If the expense is for items in multiple categories, enter a line for each category.
- Any sales tax should be prorated into each category.
- If you are not sure of the category, or the category is not listed, select “other” and write an explanation in the comments section of the form.
- If you used a COBRAS check, enter the check number.
Note: The fields below will scroll left and right.