Credit Card/Paypal Receipt
Please use this form to turn in credit card or paypal receipts
Your name
*
First Name
Last Name
Your Email
*
Ministry/Department
Payment Method Used
*
Please Select
Church Credit Card
PayPal
Walmart Card
Hobby Lobby Card
Lowe's Card
Fleet Fuel Card
Other
Please describe payment method used
Name on card
Please Select
Quinn Banister
Kirt Dauphin
Tom Francis
Tyriel McGruder
Ashley James
Monica Florez
CJ Luckey
Cody Turner
Aaron Gregory
Matt Bramlett
Braden Harris
Willy Rojas
Mandy Barnes
Ronnie Rosser
Ryle Ramos
Payee
*
Date of purchase
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Amount (in Dollars)
*
Please include tip amounts
Reason/Comments
*
File Upload
*
Browse Files
Drag and drop files here
Choose a file
Please upload a copy of the purchase receipt
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