Credit Card Expense Form
This form must accompany any credit card receipt returned to the HHS Athletic Booster Club.
Please list the receipts separately with a full description of items purchased.
To receive reimbursement, you must submit this claim within 30 days of the expenditure.
Date:
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Requested By:
*
First Name
Last Name
Email:
*
Your E-mail Address
Sport/Activity/Event/Budget Category:
*
Notes:
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Next
Itemized Expenses
Rows
Date
Vendor/Supplier
Description of Items Purchased
Amount ($)
1
2
3
4
5
6
7
8
9
10
Total Due ($):
Sales tax paid ($):
*
(If no sales tax paid then enter 0)
Receipt(s):
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Requestor Signature:
*
*
I certify that all information entered above is valid and true.
Questions? Email HHS Athletic Booster Club Treasurer at treasurer@hibritenpanthers.org
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