PTO Expense Reimbursement Request Form

Kaleidoscope PTO Reimbursement Request Form

Fill form out completely within 60 days of your purchase and email kaleidoscopepto@ksk8.com with any questions
Submitted by *

First Name Last Name
E-mail *
Date *

Month Day Year
Date
Expense Category *
Expense Description *
Amount *
Please enter a number without a dollar sign.
Take a Photo of Your Receipt (Usually for a Smartphone)
Upload a File with Your Receipt (Usually for a PC)
Signature *

Clear
Type of Reimbursement *

Paper Check
Should be Empty:

Kaleidoscope PTO Reimbursement Request Form