---
title: Expense Reimbursement Claim Form
product: PDF Generator
description: Download a printable expense reimbursement claim form in PDF. Generate editable or prefilled employee reimbursement forms using SurveyJS PDF Generator.
framework: Vanilla JS
source: https://surveyjs.io/pdf-generator/examples/pdf-hr-expense-reimbursement-claim-form-template/vanillajs
index: https://surveyjs.io/pdf-generator/examples/overview.md
---

# Expense Reimbursement Claim Form (Vanilla JS)

## Files

### `public/index.html`

```html
<div style="display: flex;">
    <div id="surveyElement" style="flex: 1 1 0%; height: 100%; min-width: 0;"></div>
    <div id="pdf-preview" style="flex: 0.7 0.7 0%; display: none">
        <embed id="pdf-preview-frame" type="application/pdf" style="width:100%; height:100%;" />
    </div>
</div>
```

### `src/index.css`

```css
/* You can add your custom CSS here. */
```

### `src/index.js`

```js
import { Model } from "survey-core";
import "survey-js-ui";
import { SurveyPDF } from "survey-pdf";
import "survey-core/survey-core.min.css";
import "./index.css";
import { json } from "./json";

function createSurveyPdfModel (surveyModel) {
    const surveyPDF = new SurveyPDF(json);
    if (surveyModel) {
        surveyPDF.data = surveyModel.data;
        surveyPDF.locale = surveyModel.locale;
        
        
    }
    
    return surveyPDF;
}
function saveSurveyToPdf (filename, surveyModel) {
    const pdfDoc = createSurveyPdfModel(surveyModel);
    if (!pdfDoc) return;

    pdfDoc.save(filename);
}

const previewDiv = document.getElementById("pdf-preview");
const previewEmbed = document.getElementById("pdf-preview-frame");
let pdfBlobUrl;

function showPdfPreview(surveyModel) {
    if (!previewDiv || !previewEmbed) return;

    const pdfDoc = createSurveyPdfModel(surveyModel);
    if (!pdfDoc) return;

    pdfDoc.raw("blob").then((blob) => {
        if (pdfBlobUrl) {
            URL.revokeObjectURL(pdfBlobUrl);
        }
        pdfBlobUrl = URL.createObjectURL(blob);
        previewEmbed.setAttribute("src", pdfBlobUrl);
        previewDiv.style.display = "block";
    });
}

function previewPdf(surveyModel) {
    if (!previewDiv) return;

    if (previewDiv.style.display !== "none") {
        previewDiv.style.display = "none";
        return;
    }

    showPdfPreview(surveyModel);
}

const survey = new Model(json);
survey.showCompleteButton = false;
survey.navigationButtonsLocation = "topBottom";
survey.addNavigationItem({
    id: "survey_save_as_file",
    title: "Download PDF",
    action: () => {
        saveSurveyToPdf("surveyResult.pdf", survey);
    }
});
survey.addNavigationItem({
    id: "survey_pdf_preview",
    title: "Preview PDF",
    visible: window.navigator.pdfViewerEnabled,
    action: () => {
        previewPdf(survey);
    }
});
survey.render(document.getElementById("surveyElement"));
```

### `src/json.js`

```js
export const json = {
  "title": "Expense Reimbursement Claim Form",
  "pages": [
    {
      "name": "details",
      "elements": [
        {
          "type": "multipletext",
          "name": "applicant-full-name",
          "maxWidth": "80%",
          "title": "Employee Details",
          "isRequired": true,
          "items": [
            { "name": "surname", "title": "Surname" },
            { "name": "first-name", "title": "First Name" },
            { "name": "department", "title": "Department" },
            { "name": "job-title", "title": "Job Title" }
          ],
          "colCount": 2,
          "itemTitleWidth": "90"
        },
        {
          "type": "signaturepad",
          "name": "receipts-area",
          "maxWidth": "20%",
          "startWithNewLine": false,
          "readOnly": true,
          "title": "Staple receipts here",
          "placeholderReadOnly": ""
        },
        {
          "type": "paneldynamic",
          "name": "all-receipts",
          "title": "Itemize Receipts",
          "templateTitle": "Receipt #{panelIndex}",
          "panelCount": 3,
          "panelsState": "firstExpanded",
          "templateElements": [
            {
              "type": "text",
              "name": "date",
              "title": "Receipt Date",
              "inputType": "date"
            },
            {
              "type": "text",
              "name": "description",
              "title": "Expense Description",
              "maxLength": 70,
              "startWithNewLine": false
            },
            {
              "type": "radiogroup",
              "name": "category",
              "title": "Category",
              "choices": [
                "Travel Expenses",
                "Accommodation",
                "Meals and Entertainment",
                "Office Supplies and Equipment",
                "Communication Expenses",
                "Professional Development",
                "Miscellaneous Business Expenses",
                "Relocation Expenses",
                "Health and Wellness"
              ],
              "colCount": 2
            },
            {
              "type": "text",
              "name": "vendor",
              "title": "Vendor"
            },
            {
              "type": "text",
              "name": "amount",
              "title": "Amount",
              "totalType": "sum",
              "totalDisplayStyle": "currency",
              "inputType": "number",
              "step": 0.1,
              "startWithNewLine": false
            }
          ],
          "confirmDelete": true,
          "confirmDeleteText": "Are you sure you want to remove this receipt from the list?",
          "addPanelText": "Add receipt"
        },
        {
          "type": "boolean",
          "name": "statement",
          "title": "In claiming the above, I confirm that the information supplied is correct and that the travelling and out-of-pocket expenses shown have been actually and necessarily incurred in connection with my attendance at the event(s).",
          "isRequired": true,
          "requiredErrorText": "Your confirmation is required.",
          "displayMode": "checkbox"
        },
        {
          "type": "signaturepad",
          "name": "signature",
          "title": "Signature",
          "signatureHeight": 100
        },
        {
          "type": "text",
          "name": "date",
          "startWithNewLine": false,
          "title": "Date",
          "inputType": "date"
        },
        {
          "type": "panel",
          "name": "office-use",
          "elements": [
            {
              "type": "text",
              "name": "office-use-date",
              "title": "Date",
              "inputType": "date"
            },
            {
              "type": "text",
              "name": "office-use-reference",
              "startWithNewLine": false,
              "title": "Reference #"
            },
            {
              "type": "boolean",
              "name": "office-use-approved",
              "title": "Approved"
            },
            {
              "type": "text",
              "name": "office-use-approver-name",
              "startWithNewLine": false,
              "title": "Approver's Name"
            }
          ],
          "title": "OFFICE USE ONLY"
        }
      ]
    }
  ],
  "questionsOnPageMode": "singlePage",
  "headerView": "advanced"
};
```

### `src/theme.js`

```js
export const themeJson = {};
```

### `package.json`

```json
{
  "dependencies": {
    "survey-core": "latest",
    "survey-js-ui": "latest",
    "survey-pdf": "latest"
  }
}
```

## Other Frameworks

- [Angular](https://surveyjs.io/pdf-generator/examples/pdf-hr-expense-reimbursement-claim-form-template/angular.md)
- [React](https://surveyjs.io/pdf-generator/examples/pdf-hr-expense-reimbursement-claim-form-template/reactjs.md)
- [Vue 3](https://surveyjs.io/pdf-generator/examples/pdf-hr-expense-reimbursement-claim-form-template/vue3js.md)
- [jQuery](https://surveyjs.io/pdf-generator/examples/pdf-hr-expense-reimbursement-claim-form-template/jquery.md)