US District Court - New Hampshire Expense (Non-Travel ) Worksheet
Receipts are required for all non-travel expenses more than $50.00 and encouraged for expenses less than $50.00. Reimbursement will be disallowed for expenses that are not itemized or for which insufficient documentation is provided.
Case Number: Case Name:
Date
Brief Description of Services
Postage & Delivery
In House Copies
Charge Per Page: $
Pgs. Amt. Pgs.
Outside Copying
Telephone Charges
Other
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs.
Amt.
Pgs. Total Pgs.
Amt.
Pgs.
Amt.
Page Totals
$
$
$
$
$
TOTAL NON-TRAVEL EXPENSES
USDCNH-56A (06/09)
$