Disbursement / Reimbursement Form

Disbursement / Reimbursement Form
Non-Officiating Reimbursements between $200-$500 must-have approval from Liaison before disbursements are provided. Non-Officiating Disbursements OVER $500 must be paid directly to the vendor. Those must have the approval of the Liaison before payment is made to the vendor.

Payments are processed every two weeks following this following schedule: https://t.ly/vLtK6
Invoice Date*

MonthDayYear
Your Name*

First NameLast Name
Your CMSA Position (Commissioner, Board Member, etc.)*
Your CMSA Email*
Commissioner Email (if you are not the commissioner)
Sport Seeking Disbursement / Reimbursement*
Season*

Please list the names of all people seeking payments. If they have not received payment from CMSA before, please include their email address. When submitting both a reimbursement AND a payment for services for the same person, please use two separate rows. If you need more rows, please use the comment box below or attach an Excel Spreadsheet.*

	Name	$ Amount	Reason
Person 1
Person 2
Person 3
Person 4
Person 5
Person 6
Person 7
Person 8
Person 9
Person 10

For non-officiating payments over $200, I have received prior approval from my board liaison:*

YesNoNot Applicable
Any additional comments
Please attach your receipts

Cancelof
I certify*

I have attached all necessary receipts and affirm that the above disbursements / reimbursesments are appropriate and adhere to the guidelines in the CMSA Policy Manual
Should be Empty:

Disbursement / Reimbursement Form

Non-Officiating Reimbursements between $200-$500 must-have approval from Liaison before disbursements are provided. Non-Officiating Disbursements OVER $500 must be paid directly to the vendor. Those must have the approval of the Liaison before payment is made to the vendor.