Reimbursement Request Form

Important:

  • Reimbursements may take 2-3 weeks to be processed.
  • Include the best mailing address to reach you. MIT campus mailing addresses are valid.
  • MIT will not reimburse for sales tax.
  • Please enter 1747202 in the Account to Charge field.
  • Receipts must display your name and indicate the item was paid for. An invoice that displays a due balance but no record of payment will not be accepted.
  • The following expense types require written approval from L&L staff before submitting this request form. Approval can be obtained by emailing laureatesleaders [at] mit.edu (laureatesleaders[at]mit[dot]edu). Requests submitted without prior approval will not be processed.
    • Conference Registration Fee
    • Conference Travel
    • Other

Questions about this form? Email laureatesleaders [at] mit.edu (laureatesleaders[at]mit[dot]edu).

Name

For example, 2022
US Citizen or Permanent Resident
Country of Citizenship
I have direct deposit setup via Atlas
Please use a mailing address that you can receive mail at for up to 3 weeks after submission of this form. Campus addresses are valid.
I am submitting multiple reimbursement requests on this form. (Maximum = 3)
Reimbursement 1
Expense Type (select one)
One file only.
5 MB limit.
Allowed types: PDF.
One file only.
10 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Reimbursement 2
Expense Type (select one)
One file only.
5 MB limit.
Allowed types: PDF.
One file only.
10 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Reimbursement 3
Expense Type (select one)
One file only.
5 MB limit.
Allowed types: PDF.
One file only.
10 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.