Can an employee e-sign the form?

Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent and attribution are demonstrable and records are retained.

What receipts must accompany a per diem claim?

Receipts are required when company policy or the accountable plan requires itemized proof; many employers require receipts for lodging and for meal incidentals above policy thresholds.

How long should HR retain completed forms?

Retain for at least three years to satisfy IRS recordkeeping (IRC §6501(a)); retain six years if HIPAA applies to any included protected health information (45 CFR §164.530(j)).

What if a form is missing a manager signature?

Missing approvals typically delay payment; the form should be returned to the submitter or approver for completion and re-submission to preserve the audit trail.

Are per diem reimbursements taxable?

Per diem under a valid accountable plan is generally nontaxable; failure to substantiate business purpose or timely return of excess amounts may require reporting as taxable wages.

Do state rules affect e-signature acceptance?

Most states follow UETA; New York uses ESRA. Check state-specific rules for notarization or special attestations before requiring them.

Electronic Signature
Templates
HR
HR Per Diem Reimbursement Form

HR Per Diem Reimbursement Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

HR Per Diem Reimbursement Form

Personal Information

Full Legal Name Employee ID Home Address

Phone

Email

Position Information

Job Title Department

Reporting Manager

Start Date with Company

Current Annual Salary

Travel / Per Diem Details

Trip Purpose:

Dates of Travel: From to

Destination (City, State):

Per Diem Coverage (select all that apply)

Meals Incidentals Lodging (if company policy allows)

Per Diem Itemization

Provide an itemized per-diem calculation for each travel day. Attach receipts where required by policy.

Date	Location	Per Diem Rate	Amount Claimed	Notes / Partial Day

Other Expense Items (Non-Per Diem)

Report any additional reimbursable expenses below. Attach original receipts for all amounts over company policy minimums.

Lodging (Total)

Mileage

Parking / Tolls

Other (specify)

Total Amount Claimed

Attachments Checklist

Original receipts for lodging, parking, tolls and other expenses

Where per-diem is claimed in lieu of receipts, I attest the per-diem calculation is consistent with company policy

Employment History

Provide the two most recent employers.

Employer 1 - Company Name Employer 1 - Job Title

Responsibilities (Employer 1) Reason for Leaving (Employer 1) Employer 2 - Company Name Employer 2 - Job Title

Responsibilities (Employer 2) Reason for Leaving (Employer 2)

Education

Highest Degree Earned Institution Graduation Date

References

Provide three professional references.

Reference 1 - Name

Reference 1 - Relationship Reference 2 - Name

Reference 2 - Relationship Reference 3 - Name

Reference 3 - Relationship

Legal Disclosures and Certifications

At-Will Employment: I understand that my employment status remains governed by the company's at-will employment policy unless otherwise agreed in writing by authorized company personnel.

Equal Opportunity: The company provides equal employment opportunity in accordance with applicable law.

Authorization: I authorize the company to contact listed previous employers and references as needed to verify employment history and to confirm the accuracy of this reimbursement request. I further authorize payroll or accounts payable to process approved reimbursement to the payee indicated on this form.

Applicant Certification

I certify that all information provided on this form and accompanying documentation is true and complete to the best of my knowledge. I certify that the expenses claimed were incurred in the performance of company business and comply with company travel and expense policies. I understand that submission of false or fabricated expenses may result in disciplinary action up to and including termination and repayment of any funds issued in error.

I understand that reimbursements are subject to review and audit; approvals may be withheld or reduced if documentation or eligibility does not satisfy company policy. I further acknowledge that any taxable portions of reimbursement will be reported in accordance with company payroll practices and applicable law.

Supplemental Information

Additional Comments (optional)

Employee Name:

Signature:

Date:

What the HR Per Diem Reimbursement Form Is

The HR Per Diem Reimbursement Form documents employee travel-related per diem claims, capturing trip dates, locations, per diem rate, and supporting receipts or substantiation. Employers use it to determine taxable versus nontaxable treatment, route approvals through HR or finance, and preserve records required for payroll and tax compliance.

Why a Standardized Per Diem Form Matters

A consistent form reduces errors, speeds approvals, and creates an auditable record for payroll and IRS review while ensuring policy adherence and defensible tax treatment.

Who Completes and Reviews This Form

Proper role separation and approvals reduce audit risk and ensure correct payroll treatment.

Employee submits travel details and attachments for reimbursement and certification.
Manager verifies business purpose, dates, and approves the claimed per diem amount.
Payroll or finance reviews approvals, performs tax treatment checks, and issues payment.

Primary Signatories and Reviewers

HR Manager

HR managers confirm policy compliance, verify substantiation, and retain the final form for recordkeeping and potential audits; they typically enforce timelines and approve exceptions.

Employee

The employee completes the form, certifies the travel purpose and expenses, and attaches required receipts; their accurate input is essential for correct tax reporting and timely reimbursement.

Essential Elements of a Professional Per Diem Form

A clear, policy-aligned form simplifies review and ensures accurate payroll and tax treatment while supporting electronic submission and retention.

Clear Fields

Separate fields for trip start/end dates, destination city/state, and business purpose to support accurate per diem calculation and substantiation.

Per Diem Calculation

Automatic or guided calculation of total per diem using daily rate multiplied by eligible days, including partial-day rules where applicable.

Receipt Attachment

Designated area to attach or reference receipts for meals or incidentals when policy requires receipts for expense validation.

Approval Workflow

Fields for manager approval, approval date, and routing logic so submissions move to payroll only after required sign-offs.

Tax Treatment

Explicit checkbox or note indicating whether amounts are taxable under IRS rules or fall under accountable plan substantiation.

Audit Trail

Space for signer name, signature, timestamp, and an audit log to support later review or IRS inquiry.

Step-by-Step: Submit a Per Diem Reimbursement

Follow these steps from completion to payment; maintain receipts and approvals to support an accountable plan and proper tax treatment.

01

Prepare Form: Complete all required fields and attach receipts in the specified formats.
02

Manager Review: Route to your manager for verification of business purpose and eligibility.
03

Finance Check: Payroll reviews tax treatment, applies withholding if required, and schedules payment.
04

Record Retention: Store the approved form and attachments according to retention policies for audit readiness.

Digital Workflow Overview for eSubmission

A streamlined eWorkflow reduces paper handling and preserves an audit trail; typical steps are upload, field placement, signer assignment, and completion.

Upload Document: Send the form to the digital platform as PDF or DOCX for configuration.
Place Fields: Add autofill, date, signature, and attachment fields where needed for validation.
Assign Signers: Add the employee and approver email addresses and set signing order if required.
Complete Signing: Signers receive invites, authenticate, sign, and the system captures timestamps and IP addresses.

Recommended Online Configuration Settings

Configure your eSubmission workflow to enforce data validation, capture an audit trail, and calculate totals automatically.

Field	Configuration
Authentication	Email plus optional SMS code for signer verification
Conditional Fields	Show receipt upload only when amounts exceed policy threshold
Formula Fields	Auto-calculate total reimbursement from rate and eligible days
Audit Trail	Enable full action log, timestamps, and IP capture

Platform and Integration Considerations

Ensure your chosen platform can export signed records to your HRIS and retain evidence for compliance and audits.

Integrations: Salesforce, NetSuite, Google Workspace, Microsoft 365
File Support: PDF, DOCX, and Excel import/export
Security: TLS and AES encryption at rest

Security and Compliance Elements to Include

Encryption: AES-256 at rest

Transport: TLS 1.2/1.3 in transit

Audit Trail: Timestamped signature events

HIPAA: BAA required for PHI

ESIGN/UETA: Legal e-signature framework

Certifications: SOC 2 Type II, ISO 27001

Key Risks and Potential Consequences

Late submission: Payroll delay; expense denial

Missing receipts: Reimbursement disallowed under policy

Improper substantiation: Taxable wages, IRS scrutiny

Incorrect rate: Overpayment recovery possible

TIN errors: Backup withholding 24%

Fraud risk: Disciplinary action, legal exposure

Common Preparation Pitfalls to Avoid

Incomplete dates or ambiguous time zones cause calculation errors and dispute.
Failing to attach required receipts or explanations triggers audit queries or declines.
Mismatched employee payroll ID or name delays routing and payment.
Using informal descriptions for business purpose increases risk of denial on review.

Timelines and Processing Expectations

Set clear internal deadlines and align them with payroll cycles and tax reporting obligations to avoid delays or misreporting.

Submission Deadline:

Submit within 30 days of travel to qualify under most accountable plans

Payroll Cutoff:

Submit before the payroll cycle cutoff for inclusion in the next pay run

Manager Approval:

Managers should review within 5 business days to prevent processing delays

Tax Reporting:

Employer reports taxable reimbursements on W-2; W-2 due to employees by Jan 31

Record Retention:

Retain substantiation per retention policy and applicable law

Vendor Pricing and Feature Snapshot for eSignature

Compare common eSignature providers across price and core features relevant to HR per diem workflows; signNow is listed first for parity.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies	Varies	Varies	Varies
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No

Use-Case Examples Showing Typical Outcomes

Real-world scenarios illustrate how consistent forms and eWorkflows reduce processing time and improve documentation.

Regional Sales Team

A sales group streamlined monthly travel claims with a standard per diem form and eSubmission

Reduced approval cycles by three days on average
The centralized records improved payroll accuracy and provided a defensible audit trail for tax reporting and client billing reconciliation.

Nonprofit Conference Travel

A nonprofit required detailed program codes for grant billing and used a tailored per diem form

Implemented conditional fields for grant vs unrestricted travel
The result preserved grant compliance, simplified expense reconciliation, and shortened reimbursement timelines.

Practical Tips for Accurate, Efficient Completion

Follow these practices to minimize review cycles and ensure substantiation aligns with IRS accountable plan rules.

Keep Complete Records

Retain original receipts and supporting documents, and attach them to the reimbursement form; complete records reduce audit risk and support accountable plan treatment when the employer must prove business purpose.

Use Consistent Rates

Apply the per diem rate from your company policy or the applicable government locality rate consistently; inconsistent rates invite questions during payroll review and potential corrective adjustments.

Document Business Purpose

Provide a concise business purpose for each travel day, including client or event identifiers; vague descriptions increase the likelihood of denial or reclassification as taxable income.

Automate Validations

Enable formula fields and conditional checks to flag missing attachments or mismatched totals before submission; automation reduces manual corrections and speeds reimbursement.

Frequently Asked Questions About the Per Diem Form

Answers to common questions on e-signatures, substantiation, retention, and tax treatment to help HR and employees complete forms correctly.

Need help? Contact support

Can an employee e-sign the form?
Yes. Electronic signatures are legally valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent and attribution are demonstrable and records are retained.
What receipts must accompany a per diem claim?
Receipts are required when company policy or the accountable plan requires itemized proof; many employers require receipts for lodging and for meal incidentals above policy thresholds.
How long should HR retain completed forms?
Retain for at least three years to satisfy IRS recordkeeping (IRC §6501(a)); retain six years if HIPAA applies to any included protected health information (45 CFR §164.530(j)).
What if a form is missing a manager signature?
Missing approvals typically delay payment; the form should be returned to the submitter or approver for completion and re-submission to preserve the audit trail.
Are per diem reimbursements taxable?
Per diem under a valid accountable plan is generally nontaxable; failure to substantiate business purpose or timely return of excess amounts may require reporting as taxable wages.
Do state rules affect e-signature acceptance?
Most states follow UETA; New York uses ESRA. Check state-specific rules for notarization or special attestations before requiring them.

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