PTO Check Request and Reimbursement Form

PTO Check Request and Reimbursement Form
Submitter Name*

First NameLast Name
Submitter Email*
example@example.com
Submitter Phone Number

Area CodePhone Number
Date

MonthDayYear
Date
Pay to the order of:*
Please list who should receive payment
Amount (to be paid/reimbursed)*
Reminder: The PTO does not reimburse for sales tax as we are a 501c3 organization. If you need a certificate of exemption, please visit https://www.juliagreen.org/pto
Invoice Number, if appliable
Type in invoice #
Expense Category (e.g. Carnival, 1st Grade Team Supplies, Grandparents Day)*
Please submit the category for your expenditure
Address to mail payment*

Street Address

Street Address Line 2

CityState

Zip Code
Description & Comments
Please add a description of the item(s) that are you requesting reimbursement
Upload receipts/payments. More than 3 receipts should include an itemized excel breakdown*

Browse Files
Please upload all receipts and payments to facilitate payment. Cancelof
For PTO purposes only - PTO Treasurer Approval
For PTO purposes only - Check number and date
Should be Empty: