OHCA Reimbursement Request

Otterhound Club of America, Inc. Reimbursement Request
This form is intended to collect information necessary to reimburse OHCA members for out-of-pocket expenses for events, publications/printed materials, postage etc. incurred in support of OHCA activities. Receipts are required with all reimbursement requests.If you have any questions, please contact Treasurer@otterhound.org
Contact Information*

First NameLast Name
Sender Email*
example@example.com
Phone Number

Area CodePhone Number
Requested Reimbursement Amount:*
Expense Description*
About the Receipt (PDF or JPEG Preferred):*

Receipt was sent via separate email to Treasurer@otterhound.orgReceipt will be uploaded into the form.Other
Please Upload Your Itemized Receipt(s)

Browse Files
Single or Multiple files, PDF or jpeg preferred (Max 100MB) Cancelof
Is this expense within the annual budget?*

YesNo - Please explain below
Explanation/Additional Information
Reimbursement Details

Note: Payment will be made based on information provided below, in most cases within 10 business days, with a valid receipt.
How would you like to be reimbursed?*

PayPalCheck
If PayPal: Please provide email address associated with your PayPal Account:
PayPal Email Address or Phone Number
If Check: Please provide "Pay to" Name and Mailing Address:
Check to be payable to:
Mailing Address for the Check and "Pay To" Name:
Please verify that you are human*
Should be Empty:

Reimbursement Details