\documentclass[]{cccbform}
\NewDocumentCommand{\ul}{m}{%
	\tikz[baseline=(word.base)]{%
		\node[inner sep=1pt] (word) {#1};
		\draw[thick] (word.south west) -- (word.south east);
	}%
}
\begin{document}
\TwoColumns{%
	\vbox to 0pt{%
	\begin{tikzpicture}[baseline]
		\def\leftMargin{1cm}
		\def\padding{0.5cm}
		\def\receiptWidth{5.5cm}
		\def\receiptHeight{10cm}
		\def\cornerLength{0.5cm}
		\coordinate (TL) at (\leftMargin,\receiptHeight);
		\coordinate (TLp) at (\leftMargin+\padding,\receiptHeight-\padding);
		\coordinate (TR) at (\leftMargin+\receiptWidth,\receiptHeight);
		\coordinate (BL) at (\leftMargin,0);
		\coordinate (BR) at (\leftMargin+\receiptWidth,0);

		\draw[thin] (TL) -- ++(\cornerLength,0);
		\draw[thin] (TL) -- ++(0,-\cornerLength);
		\draw[thin] (TR) -- ++(-\cornerLength,0);
		\draw[thin] (TR) -- ++(0,-\cornerLength);

		\node[anchor=north west, text width=\receiptWidth-2*\padding, color=black!60] at (TLp) {
			{\centering\LARGE\bfseries Kopiervorlage}\\[1ex]
			{\small\bfseries nur für \ul{Bar} bezahlte\\ Auslagen bei \ul{Barerstattung}}\\[1em]
			1. Beleg hier auflegen\\[1ex]
			2. Kopie machen\\[1ex]
			3. Beleg mit einem Streifen Klebeband oben über der Kopie befestigen\\[1em]
			4. Vorlage wieder weglegen
		};
	\end{tikzpicture}%
	}
}{%
	\LogoTitle{Beleg + Kopie}
	\par\vspace{0.4\paperheight}
	\TextField{Zweck}
	\ShortTextField{Person}
	\vspace{1.5cm}
	\Notes[Eingang \& Erstattung am / Bearbeiter]
	\vspace{1.0cm}
	\Notes[Konto / Gegenkonto / Vermerke]
	\Notes[Gebucht am / durch]
}
\end{document}
