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Per Diem Expense Form

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Per Diem Expense Form

WHEREAS, the Claimant is authorized to travel on behalf of the Company to perform duties related to the Claimant's assigned responsibilities, and the Company maintains a per diem reimbursement policy to compensate for subsistence and incidental expenses incurred during such travel; and

WHEREAS, the Claimant represents and warrants that the per diem amounts claimed are accurate, were incurred in the performance of Company business, and are eligible for reimbursement under applicable Company policy; and

WHEREAS, the parties desire to document the details of this per diem reimbursement request, the terms of payment, and the certifications and acknowledgements associated with the requested reimbursement.

Claimant Information

Travel Details

Purpose of Travel:

Travel Start Date:

Travel End Date:

Per Diem Calculation

The Claimant asserts reimbursement as set forth below. Per diem rates claimed shall conform to Company policy unless otherwise approved in writing by an authorized Company representative.

Receipts & Attachments

Receipts are required for lodging and any individual expense exceeding Company policy thresholds. Claimant shall attach original receipts or provide an authorized explanation for any receipt exceptions.

Scope of Work

Payment Terms

The Company shall reimburse the Claimant for approved per diem amounts within the payment schedule below, subject to verification of eligibility and attachment of required documentation. Payment is subject to standard payroll or accounts payable processing time.

Term and Termination

This reimbursement request pertains to the travel described above. The authorization for per diem reimbursement may be revoked or adjusted by the Company for cause, including material misrepresentation, failure to provide required documentation, or breach of Company policies.

Authorization Start Date:

Authorization End Date:

Confidentiality

The Claimant agrees that all nonpublic Company information encountered in connection with the travel and services performed is confidential. The Claimant shall not use or disclose such information except as necessary to perform the duties for which the travel was authorized. This obligation survives termination of the reimbursement authorization.

Governing Law

This Per Diem Expense Form and any dispute arising out of or relating to it shall be governed by and construed in accordance with the laws of the jurisdiction in which the Company maintains its principal place of business, without regard to conflict of laws principles.

Entire Agreement

This document, together with any required attachments and approvals, constitutes the entire agreement between the Claimant and the Company regarding the per diem reimbursement described herein and supersedes all prior negotiations, representations, or agreements, whether written or oral.

Certification

By signing below, the Claimant certifies under penalty of perjury that the information and amounts set forth in this form are true, complete, and were incurred by the Claimant in the performance of Company business. The Claimant acknowledges that false statements may subject the Claimant to disciplinary action, including repayment of funds and other remedies available to the Company.

Claimant:

By:

Date:

Authorized Approver:

By:

Date:

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What the Per Diem Expense Form Is and Why It Exists

Per Diem Expense Form is a standardized employee reimbursement document used to claim per diem allowances for travel-related meals, lodging, and incidental expenses. Employers use it to record dates, locations, purpose of travel, and calculate taxable versus nontaxable reimbursements under accountable plan rules. The form documents employee name, job title, travel dates, daily per diem rates, receipts or substantiation when required, and manager approval. Organizations use per diem forms to maintain audit trails for payroll, tax reporting, and internal controls, and to support consistent application of federal per diem rates.

Why a Clear Per Diem Expense Form Matters

Using a clear Per Diem Expense Form standardizes reimbursement, reduces errors, and supports tax compliance. Digital completion with a compliant eSignature provider, such as signNow, preserves audit trails, enforces signer attribution, and can shorten reimbursement cycles without altering legal requirements.

Why a Clear Per Diem Expense Form Matters

Who Typically Completes and Signs This Form

Corporate travelers, finance or payroll staff, and travel managers typically complete Per Diem Expense Forms to document trips, rates, and approvals for reimbursement.

  • Employees or travelers enter trip dates, destinations, purpose, and attach receipts or substantiating documents for each day of travel.
  • Finance and payroll staff verify rates, confirm accountable-plan treatment, code expense accounts, and process reimbursements on scheduled payroll runs.
  • Travel managers or supervisors approve expenses, confirm policy compliance, and resolve discrepancies before final payment is issued.

Keep copies for audit, route forms promptly, confirm manager approval before payroll processing, and retain electronic copies for recordkeeping.

Essential Fields to Include on the Form

Employee Name: Enter full legal name as on ID
Employee ID: Company-assigned ID or payroll number
Travel Dates: Start and end dates in MM/DD/YYYY format
Destination: City, state, and country of travel
Per Diem Rate: Daily meal or lodging rate applied
Total Amount: Calculated total reimbursement requested

Step-by-Step: Completing and Submitting the Form

Follow these core steps to ensure accurate completion, timely approval, and prompt reimbursement through payroll or expense systems.

  • 01
    Fill Details: Enter traveler info, dates, destinations, and per diem rate.
  • 02
    Attach Proof: Upload required receipts and any supporting documentation.
  • 03
    Obtain Approval: Submit to manager for electronic or handwritten approval.
  • 04
    Submit to Finance: Route completed form to payroll or expense system for processing.

Where to Send Completed Per Diem Forms

Choose the correct destination to match your organization’s reimbursement workflow and to align with payroll cutoff schedules.

  • Submit to Finance: Send completed forms to the finance or accounts payable team.
  • Upload to System: Upload the form into the company expense-management platform.
  • Manager Approval: Ensure a manager signs or approves electronically before payroll submission.
  • Payroll Processing: Finance queues approved claims for the next payroll cycle.

Typical Digital Configuration for Online Per Diem Forms

Set up required fields, approval routing, and attachment validation to reduce manual work and errors.

Field Configuration
Signature Field Require signer name, date, and eSignature audit trail
Attachment Field Require receipt upload for specified expense types
Approval Flow Auto-route to manager, then to finance for processing
Date Validation Enforce MM/DD/YYYY format and logical date ranges

Technical Considerations for Digital Completion and eSubmission

Validate platform encryption, audit trail features, and integrations (Salesforce, NetSuite, Google Workspace, Box) to ensure secure routing and efficient reconciliation.

  • File Formats: PDF, DOCX, or HTML accepted
  • Integrations: Connect with payroll, ERP, or cloud storage
  • Authentication: Email links, SMS codes, or stronger methods

Typical Deadlines and Timing Expectations

Understand submission windows and payroll cutoffs to avoid delayed reimbursements and ensure proper accounting.

Submission Window:

Submit forms within 30 days of travel end to meet most company policies

Manager Approval:

Obtain approval before the payroll cutoff for timely reimbursement

Payroll Cutoff:

Finance processes approved claims according to established payroll schedules

Tax Reporting:

Retain records to support tax treatment and year-end reporting if required

Records Requests:

Respond to audits or inquiries promptly to avoid compliance issues

Key Processing Milestones from Travel to Reimbursement

A typical processing sequence includes submission, approval, finance review, and payroll reimbursement; each stage has specific actions and time windows.

01

Travel Completed

Employee returns and documents trip details and receipts

02

Form Submitted

Employee files form in expense system or sends to finance

03

Manager Approval

Supervisor reviews, approves, or requests clarifications

04

Payroll Reimbursement

Finance schedules payment in next eligible payroll run

Common Preparation Errors to Avoid

  • Missing receipts or incomplete substantiation often triggers manual follow-up and delays reimbursement and audit clearance.
  • Incorrect dates or destination information can cause ineligible per diem calculations and require resubmission of corrected forms.
  • Applying the wrong per diem rate for a location or date range leads to overpayment or underpayment and increases reconciliation work.
  • Unsigned or unapproved forms are rejected by finance and must be returned to the employee, lengthening processing time.

Potential Penalties and Compliance Risks

1099 Late Penalty: Per IRC §6721: $60–$330 per form
Intentional Disregard: Per IRC §6721: $660+ per form
Backup Withholding: 24% withholding rate if TIN incorrect
I-9 Paperwork Risk: 8 CFR §274a.2: $281–$2,789 per violation
Payroll Fines: Late payroll can attract state labor penalties
Data Breach Risk: HIPAA or state breach penalties if PHI exposed

eSignature Pricing and Feature Comparison for Per Diem Workflows

When selecting an eSignature provider for per diem forms, compare starting price, trial availability, bulk-send capabilities, audit trail, HIPAA support, and envelope limits.

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 free trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes Varies
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently Asked Questions and Quick Answers

Answers to common questions about validity, signatures, receipts, corrections, and recordkeeping for Per Diem Expense Forms.


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