Personal Paid Expense Request

Personal Paid Expense Request

Please fill out the form to request for personal paid expenses.
In TheVillage, our mission is to provide a supportive community for our members and help them achieve their goals. We recognize that many of our members are facing economic struggles, which is why we created TheVillage concept. Our aim is to be a resourceful platform for our members and offer financial assistance to those who need it.

To become a paid expense recipient in TheVillage, you will need to follow the necessary steps outlined in the Expense Request. This request includes a detailed description of the process, including the eligibility criteria, the types of expenses that are covered, and the required documentation. We believe that transparency is essential in this process, which is why we have included a breakdown of the expenses that we cover and the corresponding reimbursement rates.

We understand that financial assistance can be a sensitive issue, which is why we treat all requests with the utmost confidentiality and respect. We are committed to ensuring that our members receive the support they need to thrive and succeed. We encourage all eligible members to apply for this program and take advantage of the resources we have to offer.
Full Name*

First NameLast Name
Email
example@example.com
Expense Details

Please provide details of the expense for which you are requesting reimbursement.
Expense Date*

MonthDayYear
Date
Expense Category*

Cell PhoneRent/MortgageMedical BillCar/ Home RepairOther
Expense Amount (USD)*
In TheVillage, we believe in supporting individuals who face financial difficulties and those who have contributed positively to the community. We understand that life can be unpredictable, and financial struggles can arise unexpectedly. At the same time, we also recognize the importance of acknowledging the efforts of those who have made a difference in their community. Therefore, we have created a financial support program that provides aid to those individuals who find themselves in uniquely challenging financial situations or have stood out in their contributions to the community in an impactful way deserving of such gift. However, we do have to be selective in choosing the recipients of our financial aid. Our team carefully evaluates each request and considers several factors, such as the severity of the financial situation, the impact of the community contributions, and the available funds. If you are facing financial challenges or have made a positive impact in your community, we encourage you to share your story with us. Please let us know the reason for your payment request and explain why you believe you should be considered for this incentive provided by TheVillage. We are committed to helping those in need and making a positive difference in our community.
Your answer above
If you are selected to receive financial aid, you will be required to provide documentation of the expense for which you are seeking assistance. This documentation will be used to verify that the expense is legitimate and that the amount being requested is accurate. You should ensure that the documentation is complete, accurate, and contains all the necessary information. Failure to provide adequate documentation may result in a delay in processing your application or even a denial of your request for financial aid.

YesNo
Document Upload*

Cancelof
We appreciate your dedication to TheVillage and understand that your time is valuable. We want to make sure you have a clear understanding of the review process and what to expect. Please allow us up to 7 business days to review your request. During this time, we will carefully evaluate your request and take into consideration various factors, including the urgency and priority of your request. Once we have reviewed your request, we will make a decision and notify you accordingly within two weeks. If your request is denied, please understand that it does not imply that you do not deserve assistance. We may be assisting other members or have other obligations at the time, which might prevent us from fulfilling your request. Please do not be discouraged and feel free to submit another request at a later time. To confirm that you have read and understood the Paid Expense Request terms, please provide your full name and the date in the space provided. If you have any questions or concerns regarding the review process or any other matters. Don't hesitate to contact us. We are here to help you.
Your answer above
Signature

Powered by Jotform SignClear
Should be Empty:

Personal Paid Expense Request

Expense Details