LTJBSA Expense Form

LJTBSA Expense Reimbursement Form

Please allow 5 days for reimbursement to be paid.
Today's Date

YearMonthDay
4 digit year, 2 digit month, 2 digit dayDate
Your Name

First NameLast Name
Your Email
example@example.com
Your Phone
Format: (000) 000-0000.
Expense Type
Reimbursement Method
Reimbursement Method
Pay To
Individual Name or Organization
Phone
Please enter a valid phone numberFormat: (000) 000-0000.
Email
example@example.com
Please enter your umpire expense in the table below using the following template:
- Date = Today's Date
- Vendor = Name of your League (i.e. River League or "Scrimmage")
- Classification = Officials
- Item Description = Your Full Team Name (i.e. "Storm 7u 2031 Jones")
- Amount = Amount requested
Upload a screenshot of your game schedule (i.e. GameChanger screenshots of the game or games you are requesting money for) as the receipt.

You will be contacted by the Treasurer to pick up your cash.

Expenses

Receipts must show vendor name, date of purchase, and amount paid.

Please use your camera phone to take pictures of all paper receipts for upload. If you do not include a receipt you may not be reimbursed for an expense.
Cancelof
Signature
Summary
Expenses
Should be Empty:

LJTBSA Expense Reimbursement Form