Expense Reimbursement Request

Expense Reimbursement Request
Payment Info
Delivery Method*
Have you submitted your ACH information to the Administrative Office?*

YesNo
Contact Info
Name*
Company Name or Individual's First & Last
Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
Request 1
1 - Ministry/Cost Center *
1 - Administration*
Expense Type
1 - Buildings & Grounds*
Expense Type
1 - Campus*
Expense Type
1 - Children's Ministry*
Expense Type
1 - Congregational*
Expense Type
1 - Creative Arts*
Expense Type
1 - Mature Adults*
Expense Type
1 - Missions*
Expense Type
1 - Singles/Young Marrieds*
Expense Type
1 - Sports*
Expense Type
1 - Young Families*
Expense Type
1 - Youth & Family*
Expense Type
Event Details
1 - What was business/ministry purpose of the expense?*
Describe what was paid for and the business/ministry purpose for the expense.
1 - Date of Event*

MonthDayYear
1 - People in Attendance?*
List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
Purchase Info
1 - Expense Amount*
1 - Where was the item purchased?*
1 - Date of Purchase*

MonthDayYear
1 - Receipt?*
1 - Provide Explanation:*
1 - Attach Receipt (Please upload either a JPEG or PNG image file)*

Cancelof
Add another request?

NoYes
- Request 2
- 2 - Ministry/Cost Center *
- 2 - Administration*
  Expense Type
- 2 - Buildings & Grounds*
  Expense Type
- 2 - Campus*
  Expense Type
- 2 - Children's Ministry*
  Expense Type
- 2 - Congregational*
  Expense Type
- 2 - Creative Arts*
  Expense Type
- 2 - Mature Adults*
  Expense Type
- 2 - Missions*
  Expense Type
- 2 - Singles/Young Marrieds*
  Expense Type
- 2 - Sports*
  Expense Type
- 2 - Young Families*
  Expense Type
- 2 - Youth & Family*
  Expense Type
- Event Details
- 2 - What was business/ministry purpose of the expense?*
  Describe what was paid for and the business/ministry purpose for the expense.
- 2 - Date of Event*
  
  MonthDayYear
- 2 - People in Attendance?*
  List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
- Purchase Info
- 2 - Expense Amount*
- 2 - Where was the item purchased?*
- 2 - Date of Purchase*
  
  MonthDayYear
- 2 - Receipt?*
- 2 - Provide Explanation:*
- 2 - Attach Receipt (Please upload either a JPEG or PNG image file)*
  
  Cancelof
- Add another request?
  
  NoYes
- Request 3
- 3 - Ministry/Cost Center *
- 3 - Administration*
  Expense Type
- 3 - Buildings & Grounds*
  Expense Type
- 3 - Campus*
  Expense Type
- 3 - Children's Ministry*
  Expense Type
- 3 - Congregational*
  Expense Type
- 3 - Creative Arts*
  Expense Type
- 3 - Mature Adults*
  Expense Type
- 3 - Missions*
  Expense Type
- 3 - Singles/Young Marrieds*
  Expense Type
- 3 - Sports*
  Expense Type
- 3 - Young Families*
  Expense Type
- 3 - Youth & Family*
  Expense Type
- Event Details
- 3 - What was business/ministry purpose of the expense?*
  Describe what was paid for and the business/ministry purpose for the expense.
- 3 - Date of Event*
  
  MonthDayYear
- 3 - People in Attendance?*
  List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
- Purchase Info
- 3 - Expense Amount*
- 3 - Where was the item purchased?*
- 3 - Date of Purchase*
  
  MonthDayYear
- 3 - Receipt?*
- 3 - Provide Explanation:*
- 3 - Attach Receipt (Please upload either a JPEG or PNG image file)*
  
  Cancelof
- Add another request?
  
  NoYes
- Request 4
- 4 - Ministry/Cost Center *
- 4 - Administration*
  Expense Type
- 4 - Buildings & Grounds*
  Expense Type
- 4 - Campus*
  Expense Type
- 4 - Children's Ministry*
  Expense Type
- 4 - Congregational*
  Expense Type
- 4 - Creative Arts*
  Expense Type
- 4 - Mature Adults*
  Expense Type
- 4 - Missions*
  Expense Type
- 4 - Singles/Young Marrieds*
  Expense Type
- 4 - Sports*
  Expense Type
- 4 - Young Families*
  Expense Type
- 4 - Youth & Family*
  Expense Type
- Event Details
- 4 - What was business/ministry purpose of the expense?*
  Describe what was paid for and the business/ministry purpose for the expense.
- 4 - Date of Event*
  
  MonthDayYear
- 4 - People in Attendance?*
  List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
- Purchase Info
- 4 - Expense Amount*
- 4 - Where was the item purchased?*
- 4 - Date of Purchase*
  
  MonthDayYear
- 4 - Receipt?*
- 4 - Provide Explanation:*
- 4 - Attach Receipt (Please upload either a JPEG or PNG image file)*
  
  Cancelof
- Add another request?
  
  NoYes
- Request 5
- 5 - Ministry/Cost Center *
- 5 - Administration*
  Expense Type
- 5 - Buildings & Grounds*
  Expense Type
- 5 - Campus*
  Expense Type
- 5 - Children's Ministry*
  Expense Type
- 5 - Congregational*
  Expense Type
- 5 - Creative Arts*
  Expense Type
- 5 - Mature Adults*
  Expense Type
- 5 - Missions*
  Expense Type
- 5 - Singles/Young Marrieds*
  Expense Type
- 5 - Sports*
  Expense Type
- 5 - Young Families*
  Expense Type
- 5 - Youth & Family*
  Expense Type
- Event Details
- 5 - What was business/ministry purpose of the expense?*
  Describe what was paid for and the business/ministry purpose for the expense.
- 5 - Date of Event*
  
  MonthDayYear
- 5 - People in Attendance?*
  List all names (first and last), one name per line. If more than 12 people, just put the number of people in attendance.
- Purchase Info
- 5 - Expense Amount*
- 5 - Where was the item purchased?*
- 5 - Date of Purchase*
  
  MonthDayYear
- 5 - Receipt?*
- 5 - Provide Explanation:*
- 5 - Attach Receipt (Please upload either a JPEG or PNG image file)*
  
  Cancelof
- Submit Request
- Total Amount Requested
  Total from all receipts.
- Person Placing this Request*
- Should be Empty:

Expense Reimbursement Request

Payment Info

Contact Info

Request 1

Request 2

Request 3

Request 4

Request 5

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