Employee Site Allowance Request

Employee Site Allowance Request

Use this form to request a site allowance for work performed at a client or project location. Complete all sections and attach estimated receipts or supporting documentation. Submission of this form constitutes employee certification of the statements below and authorization to verify employment and references as necessary.

Personal Information

Position Information

Site Allowance Details

Allowance Type(s) requested (check all that apply):

Estimated Itemized Costs

Provide an itemized estimate. Attach additional pages if necessary.

Advance requested: Yes No

Documentation and Conditions

Required documentation for reimbursement or advance settlement (checkboxes confirm inclusion at submission):

By submitting this request, the employee acknowledges that allowances are subject to company policy, may be taxable income under applicable law, and that reimbursements require original receipts unless otherwise authorized. Funds advanced must be substantiated; unsubstantiated advances may be recovered through payroll deduction or other lawful means.

Manager / Finance Review (for internal use)

Manager Acknowledgement:

Manager Comments:

Finance Review:

Employment History

Provide the two most recent employers.

Dates Employed: From to

Dates Employed: From to

Education

References

Provide three professional references.

Legal Disclosures & Certifications

At-Will Employment: Nothing in this request or any allowance approval alters the at-will nature of employment. Either the employee or the company may terminate employment at any time, with or without cause or notice, unless a separate written agreement states otherwise.

Equal Opportunity: The company provides equal employment opportunity and will not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other status protected by law.

Certification: I certify that all information provided on this form and in any attachments is true, complete, and submitted in good faith for legitimate business purposes. I understand that falsification, omission, or misrepresentation of facts may result in denial of the allowance, recovery of funds, and disciplinary action up to and including termination.

Authorization: I authorize the company to contact my prior employers and the references listed above for verification of information. I further authorize any third parties to provide requested employment and reference information to the company and its agents.

Taxability: I acknowledge that certain allowances may be reportable as taxable income and agree to provide required documentation for tax reporting and withholding as required by company policy and applicable law.

Applicant Certification

I certify under penalty of disciplinary action that the foregoing statements are true and accurate. I understand that approval of this request is subject to manager and finance review and that any approved funds must be used only for legitimate site expenses and accounted for in accordance with company expense policy.

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