Changeflow GovPing Government & Legislation Missouri State Expense Report Template
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Missouri State Expense Report Template

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Summary

The State of Missouri provides a standardized Monthly Expense Report form (MO 300-1189, revised 10-2021) for state employees to document reimbursable business expenses. The form captures employee identification, travel dates and mileage, meal and lodging costs, and requires certification that expenses were necessary for state business and have not been reimbursed from other sources. The form includes fields for department coding, approval signatures, and optional military service disclosure for Missouri veterans' services referral.

“I hereby certify the above claim is correct, that these expenses were necessary to conduct state business, that payment has been made from personal funds for which I have not been reimbursed, nor will I receive from any source any payment for these expenses.”

MO OA , verbatim from source
Published by MO OA on oa.mo.gov . Detected, standardized, and enriched by GovPing. Review our methodology and editorial standards .

About this source

GovPing monitors Missouri OIG for new government & legislation regulatory changes. Every update since tracking began is archived, classified, and available as free RSS or email alerts — 3 changes logged to date.

What changed

This document establishes a standardized expense report template for Missouri state government employees and departments. The form sets out required fields for employee identification, travel expense documentation including mileage, meals, lodging, and requires a certification statement confirming expenses are necessary and unreimbursed. State employees submitting travel reimbursement claims must use this form as provided by the Office of Administration. No modifications to rates or formulas are permitted on the form itself.

Archived snapshot

Apr 22, 2026

GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.

STATE OF MISSOURI

MONTHLY EXPENSE REPORT

FOR MONTH OF PAGE ______ OF ______

DEPARTMENT/DIVISION OR INSTITUTIONDO NOT MODIFY RATES OR FORMULAS. EMPLOYEE NAME (LAST, FIRST) VENDOR CODE (LAST 4 DIGITS OF SOCIAL SECURITY NUMBER)

xxx-xx-_______________________

OFFICE ADDRESS WO RK PHONE NO. UNIT/COUNTY LOCATION CODE OR DOCUMENT NO.

OVER- STANDARD RET FLEET BREAK-DATE FROM/TO & PURPOSE NIGHT LUNCH DINNER LODGING OTHER* TOTAL MILES (X) MILES FASTSTAY (X)

TOTALS OF ABOVE 4 TOTALS FROM OTHER PAGES 4 TOTAL STANDARD MILES 4 AT ¢ PER MILE 4 TOTAL FLEET MILES 4 AT ¢ PER MILE 4

TOTAL INSTATE TOTAL OUTSTATE TOTAL REIMBURSABLE EXPENSE 4$ $

DATE *EXPLANATION OF OTHER

I hereby certify the above claim is correct, that these expenses were necessary to conduct state business, that payment has been made from personal funds for which I have not been reimbursed, nor will I receive from any source any payment for these expenses.

APPROVAL SIGNATURE CLAIMANT SIGNATURE DATE

TITLE DATE TITLE OFFICIAL DOMICILE

APPR UNIT ACTIVITY FUNCTION OBJ/SUB JOB NUMBER REP CAT AMOUNTFUND AGCY ORG/SUBVERIFIED BY AND DATE / / / / / /CODED BY AND DATE / / / / / /CK CATEGORY / / / /  Yes  N oHAVE YOU OR AN IMMEDIATE FAMILY MEMBER SERVED IN THE U.S. ARMED FORCES?  Yes  N oIF YES, WOULD YOU LIKE INFORMATION ABOUT MILITARY-RELATED SERVICES IN MISSOURI?

MO 300-1189 (10-2021) SAM II

0.5500.340

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Last updated

Classification

Agency
MO OA
Instrument
Notice
Branch
Executive
Legal weight
Non-binding
Stage
Final
Change scope
Minor

Who this affects

Applies to
Government agencies
Industry sector
9211 Government & Public Administration
Activity scope
Expense reimbursement Travel documentation State employee benefits
Geographic scope
US-MO US-MO

Taxonomy

Primary area
Government Contracting
Operational domain
Compliance

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