PTSA Reimbursement & Payment Form

Expense List

Total Cost
Receipt

Cancelof
How would you like to receive your funds?
Electronic Payment Information
Please note that when selecting Electronic/ACH Transfer:
- Your phone number is required to add to our payment system.
- SPS email addresses will block communication from Banner Bank, which is needed to set you up in our payment system.
- Routing Number and Account Number would be helpful but is not required, especially if you've received electronic payments in the past.
Routing Number
Account Number
Is this payment urgent?
If urgent, please provide details.
Please explain the reasoning for this request to be considered urgent.Invoice due date, payment required in-person for event, etc.
Link to pay:
Check Payment Information
Make Payment To:
Company/Person Direct Check Payment will be written out to
Address to Mail Check

Street Address

Street Address Line 2

CityState

Zip Code
Notes
If the information above is incorrect and a stop payment is required, $30 will be deducted from the amount issued for reimbursement.
Should be Empty:

Reimbursement or Payment Form