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Letter Factory Miscellaneous Dorm Resident Move Reimbursement
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Copy Directly on to Unit Letter Head!

## MON YEAR

MEMORANDUM FOR SQU/CCF
          ### CES/???
          ### CPTS/FAP

FROM: RANK FNAME LNAME

SUBJECT: Certification of Repayment of Utility Expenses

1. Request repayment for the attached bill, totaling $85.00, for telephone relocation which occurred as a result of a government-directed move within the dormitory. The $85.00 total encompasses two directed moves.



2. Repayment should be made to RANK FNAME LNAME, SSN 000000000. My mailing address is ENTER HERE.

                                                                                     (SIGNATURE BLOCK)

1ST Ind, SQU/CCF

TO: ### CES/CEH

1. I certify the above individual was directed to move and qualifies for reimbursement of the stated charges

Reminder, the Signature Block is 5 spaces below the last line of text.