Reimbursement and Check Requests
Please fill out this form and upload any receipts.
Name
*
First Name
Last Name
Email
*
example@example.com
Report Type
*
Please Select
Reimbursement Request (for self)
Check Request (for another/vendor)
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Reimbursement Request
All expenses must be pre-approved to guarantee reimbursement.
Check Request
All expenses must be pre-approved.
Name of person/company to receive check
*
Repayment Method
*
Please Select
ACH payment
Paper Check (mailed)
Payment Requested By
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Checks are processed on Fridays. We will do our best to accommodate when faster repayment is requested.
Is this your first time receiving an ACH repayment or do you need to update your bank account?
*
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Credit Card Expense Report
Please fill out an expense for each charge listed on your monthly statement. Purchase descriptions should include the organization or event name (ie. Wednesday meal for Teen Soyo)
Expenses List
Please fill out an expense for each receipt. Purchase descriptions should include the organization or event name (ie. Wednesday meal for Teen Soyo)
Expense List
*
Total Cost ($)
*
Receipt Upload
Browse Files
Drag and drop files here
Choose a file
All expenses must have a receipt to get reimbursed. Pictures or scans of receipts are acceptable. If you do not have a digital copy, please submit unstapled receipts to church office
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Missing Receipt
I am missing one or more receipts
Missing Receipt Form
Please fill out details for each missing receipt.
Missing Receipt List
*
Signature
*
By signing below, I am certifying that the above amounts are appropriate expenses incurred by me.
Comments / Questions
Signature
I certify that all information entered above is valid and true
Typed Name of Requestor
*
Typing your name here confirms the information above is accurate and receipts are included (or explained if missing).
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