Check Request Form

For Reimbursement or to Request a check:
1. Complete this form.
2. Attach receipts and/or invoice and approved contract or grant when applicable. Treasurer will not issue a check without this documentation. No exceptions.
3. Make a copy for your committee chair/binder. Requester needs to keep a copy of all documents.
4. Reimbursements must submitted within 90 days of purchase. After 90 days, funds will be considered a donation to PTA and may not be reimbursed.
5. Both check signers will review proper documentation before signing and issuing a check.
6. Contact the PTA treasurer at treasurer@cottagelakepta.org with any questions.
RAINY DAY FUND REIMBURSEMENTS: In order to be reimbursed using rainy day funds, items must be used in/for the classroom and not for personal use. Items should directly support the classroom and every child.

Expense Category

Make sure to enter the correct label for your expense so it’s categorized accurately in the budget. Refer to the list below for the most commonly used labels. If you're not sure, select "Other" and add a note to indicate that you're unsure.
To be reimbursed:*
TOTAL REIMBURSMENT OR TOTAL REQUEST AMOUNT:
Make checks payable to:
Requested by:
Check delivery:
Mailing address: (if checks to be mailed)
Phone Number (Requester)
Format: (000) 000-0000.
Email
example@example.com
Date requested

MonthDayYear
Date
For Treasurer's Use Only Check #
Check #
Date

MonthDayYear
Date
Amount
Receipt Required Upload Here

Cancelof
Should be Empty: