Cash Expense Form for SRM

Cash Expense Allocation Form for SRM/

This form is an allocation of SRM finances that have been designated to you or your team for ministry use. For example: If you have been given cash; at the end of each month you must submit this form and provide receipts for each transaction. Please provide a separate form for each MONTH DO NOT COMBINE MONTHS.
Your Name*

First nameLast name
Team Name
If applicable
Institution or person whom you received the funds from?*
Mission's Location where the funds were used:*
Your mailing address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number*
E-mail*
Your E-mail Address
Expense Detail

Only list the expenses for the month selected below. Please add each month separate.
Month Date*

Expenses List*

	Purchase Date mm/dd/yyyy/	Ministry Category (Kids ministry, Youth, Refugees)	Product/Service Description (Gas, Food, Travel, Supplies)	Cost Local Currency	COST in USD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30

Additional Expenses List

	Purchase Date mm/dd/yyyy	Ministry Category (Kids ministry, Youth, Refugees)	Product/Service Description (Gas, Food, Travel, Supplies)	Cost Local Currency	COST in USD
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
52
53
54
55
56
57
58
59
60
71

Total from Expense list in Foreign Currency (only use if expanses are not USD)*
Total from Expense list in USD*
Please note that handwritten checks must contain the following information:
• Date
• Who issued (seller's name, Shop name, phone number, etc.)
• Description and quantity of goods / services
• Cost of goods / services
• Seller's last name, first name and signature.
All checks (both printed and handwritten) must be fully scanned and of good quality.
Upload any Receipts Here*

To scan your receipts open notes app on your iPhone, click on camera icon, select scan documents and upload all your receipts. Please try to scan multiple receipts at once. If you don't have an iPhone visit apple.com NOTE: Your iPhone purchase does not qualify for a ministry expense at this time.
Cancelof
I certify*

I certify that all information and attached receipts have been used solely for the purpose of SRM and not for personal use. I acknowledge that I have used THE FEAR of THE LORD in making SRM transactions. I understand that by providing false information, I may be liable to repay with interest. I promise that all information entered in this form is valid and true.
Signature*

Clear
Should be Empty:

	Purchase Date mm/dd/yyyy	Ministry Category (Kids ministry, Youth, Refugees)	Product/Service Description (Gas, Food, Travel, Supplies)	Cost Local Currency	COST in USD
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
52
53
54
55
56
57
58
59
60
71

	Purchase Date mm/dd/yyyy	Ministry Category (Kids ministry, Youth, Refugees)	Product/Service Description (Gas, Food, Travel, Supplies)	Cost Local Currency	COST in USD
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
52
53
54
55
56
57
58
59
60
71

Cash Expense Allocation Form for SRM/

	Purchase Date mm/dd/yyyy	Ministry Category (Kids ministry, Youth, Refugees)	Product/Service Description (Gas, Food, Travel, Supplies)	Cost Local Currency	COST in USD
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
52
53
54
55
56
57
58
59
60
71