CrossRoads Purchase Order

CrossRoads Purchase Order

Do not put any personal financial information on this form
Requested By*

First NameLast Name
Email*
example@example.com
Purpose of Reimbursement*
ACCOUNT ALLOCATION

Please select the budget account below that your reimbursement should be paid from in the Account Allocation field. Then enter the total "before tax" amount for that account (will be the total before tax amount of all the receipts entered below for that budget account). If your receipts need to be paid from more than one budget account, select "Add Additional Budget Accounts" button and repeat above step.
Account Allocation*
RECEIPTS

Enter each receipt on a separate line with merchant name in column 1, enter the "before tax" amount in column 2, and enter the tax amount, if any, in column 3.

The form will automatically total up your reimbursement that you are requesting below the receipt table.

Receipts*

Pre-Tax Amount
Total Tax
Total Reimbursement
SCAN RECEIPTS

Please attach supporting documentation or receipts to this form. Click the "Browse Files" button below to upload receipts one at a time from your phone or your computer. Be sure the pics or files you've submitted are readable.

If you prefer to submit original paper forms, please fill out this online form first and then submit your forms for reimbursement to Cindy in the office.
Scanned Receipts

Browse Files
Please scan receipts as separate files. Pictures of the receipts work too as long as they are readable. Cancelof
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