BOARD of DIRECTORS Reimbursement Request Form

Reimbursement Request Form

For ACCT Board of Directors use
1. Please submit one reimbursement request form per trip/project.
2. ACCT will reimburse for approved meals at the following rates. Please note that if ACCT picks up a meal we ask that you not claim that meal rather only meals you are eligible for that are not already being covered by ACCT in another way:
  Breakfast = $14
  Lunch = $15
  Dinner = $29
  
  For all other expenses:
3. Scan your travel and other receipts as PDF files as you incur expenses (please make an effort to make these files reasonably small). If you have an iPhone, you can use the Notes app to scan receipts as pdfs - and its free. If you have an android phone, you can use the google drive app - and it’s free.
4. Name your receipts as follows:
  1. yyyy-mm-dd_Vendor_Amount.pdf
  2. Example: 2022-07-25_OfficeDepot_30.44.pdf
  3. Example 2: 2022-07-30_United_350.22.pdf
5. Choose the total number of additional expense lines you will need to complete your reimbursement request. You should have an expense line per receipt.
6. Enter the required information in the form fields.
7. Enter the Account for the expense. There is a dropdown list.
8. Enter the payee or vendor, for example: Office Depot.
9. Enter the amount of the expense.
10. Upload the pdf of the receipt by dragging and dropping the file into the upload window.
11. If you do not have or cannot find a receipt and have exhausted all options to get one, you will be asked to complete a missing receipt affidavit and file with the expense report.
Notes:
1. All expenses must be budgeted for and approved by the BOD as part of the annual planning and budgeting process. Extraordinary or unanticipated expenses will need prior approval from the Executive Director – no exceptions.
2. Keep all of your original receipts until your expense report is approved, we need to make sure they are all legible.
3. Once your expense statement is approved - it will be entered into QuickBooks; paid by check on our regular Accounts Payable schedule.
4. If you have any questions about any of this, please ask a staff member.
Name*

First NameLast Name
Email*
example@example.com
Phone Number

Country CodeArea CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Project / Purpose*
Make Check payable to:*
What are your claims?

Meals - Per Diem (for meals during travel or non-provided meals on meeting days)Miles in personal vehicleOther line items (other travel, etc.)
Total number of other expense lines needed.*
Meals will be reimbursed at the following per diem rates:
Breakfast = $14
Lunch = $15
Dinner = $29

Please enter the number of each type of meal that are you claiming below. Please do exclude any group meals that were paid for by the Association.
Breakfasts
Lunches
Dinners
Total From Meals
Miles driven in personal vehicle
Standard Mileage Claim
Date of Expense*

MonthDayYear
Date
Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
Account*
Payee or Vendor*
Comments or additional information.
Amount*
Receipt (PDF)*

Cancelof
2) Date of Expense*

MonthDayYear
Date
2) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
2) Account*
2) Payee or Vendor*
2) Comments or additional information.
2) Amount*
2) Receipt (PDF)*

Cancelof
3) Date of Expense*

MonthDayYear
Date
3) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
3) Account*
3) Payee or Vendor*
3) Comments or additional information.
3) Amount*
3) Receipt (PDF)*

Cancelof
4) Date of Expense*

MonthDayYear
Date
4) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
4) Account*
4) Payee or Vendor*
4) Comments or additional information.
4) Amount*
4) Receipt (PDF)*

Cancelof
5) Date of Expense*

MonthDayYear
Date
5) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
5) Account*
5) Payee or Vendor*
5) Comments or additional information.
5) Amount*
5) Receipt (PDF)*

Cancelof
6) Date of Expense*

MonthDayYear
Date
6) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
6) Account*
6) Payee or Vendor*
6) Comments or additional information.
6) Amount*
6) Receipt (PDF)*

Cancelof
7) Date of Expense*

MonthDayYear
Date
7) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
7) Account*
7) Payee or Vendor*
7) Comments or additional information.
7) Amount*
7) Receipt (PDF)*

Cancelof
8) Date of Expense*

MonthDayYear
Date
8) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
8) Account*
8) Payee or Vendor*
8) Comments or additional information.
8) Amount*
8) Receipt (PDF)*

Cancelof
9) Date of Expense*

MonthDayYear
Date
9) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
9) Account*
9) Payee or Vendor*
9) Comments or additional information.
9) Amount*
9) Receipt (PDF)*

Cancelof
10) Date of Expense*

MonthDayYear
Date
10) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
10) Account*
10) Payee or Vendor*
10) Comments or additional information.
10) Amount*
10) Receipt (PDF)

Cancelof
11) Date of Expense*

MonthDayYear
Date
11) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
11) Account*
11) Payee or Vendor*
11) Comments or additional information.
11) Amount*
11) Receipt (PDF)*

Cancelof
12) Date of Expense*

MonthDayYear
Date
12) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
12) Account*
12) Payee or Vendor*
12) Comments or additional information.
12) Amount*
12) Receipt (PDF)*

Cancelof
13) Date of Expense*

MonthDayYear
Date
13) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
13) Account*
13) Payee or Vendor*
13) Comments or additional information.
13) Amount*
13) Receipt (PDF)*

Cancelof
14) Date of Expense*

MonthDayYear
Date
14) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
14) Account*
14) Payee or Vendor*
14) Comments or additional information.
14) Amount*
14) Receipt (PDF)*

Cancelof
15) Date of Expense*

MonthDayYear
Date
15) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
15) Account*
15) Payee or Vendor*
15) Comments or additional information.
15) Amount*
15) Receipt (PDF)*

Cancelof
16) Date of Expense*

MonthDayYear
Date
16) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
16) Account*
16) Payee or Vendor*
16) Comments or additional information.
16) Amount*
16) Receipt (PDF)*

Cancelof
17) Date of Expense*

MonthDayYear
Date
17) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
17) Account*
17) Payee or Vendor*
17) Comments or additional information.
17) Amount*
17) Receipt (PDF)*

Cancelof
18) Date of Expense*

MonthDayYear
Date
18) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
18) Account*
18) Payee or Vendor*
18) Comments or additional information.
18) Amount*
18) Receipt (PDF)*

Cancelof
19) Date of Expense*

MonthDayYear
Date
19) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
19) Account*
19) Payee or Vendor*
19) Comments or additional information.
19) Amount*
19) Receipt (PDF)*

Cancelof
20) Date of Expense*

MonthDayYear
Date
20) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
20) Account*
20) Payee or Vendor*
20) Comments or additional information.
20) Amount*
20) Receipt (PDF)*

Cancelof
21) Date of Expense*

MonthDayYear
Date
21) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
21) Account*
21) Payee or Vendor*
21) Comments or additional information.
21) Amount*
21) Receipt (PDF)*

Cancelof
22) Date of Expense*

MonthDayYear
Date
22) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
22) Account*
22) Payee or Vendor*
22) Comments or additional information.
22) Amount*
22) Receipt (PDF)*

Cancelof
23) Date of Expense*

MonthDayYear
Date
23) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
23) Account*
23) Payee or Vendor*
23) Comments or additional information.
23) Amount*
23) Receipt (PDF)*

Cancelof
24) Date of Expense*

MonthDayYear
Date
24) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
24) Account*
24) Payee or Vendor*
24) Comments or additional information.
24) Amount*
24) Receipt (PDF)*

Cancelof
25) Date of Expense*

MonthDayYear
Date
25) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
25) Account*
If unknown, use SUSPENSE
25) Payee or Vendor*
25) Comments or additional information.
25) Amount*
25) Receipt (PDF)*

Cancelof
26) Date of Expense*

MonthDayYear
Date
26) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
26) Account*
26) Payee or Vendor*
26) Comments or additional information.
26) Amount*
26) Receipt (PDF)*

Cancelof
27) Date of Expense*

MonthDayYear
Date
27) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
27) Account*
27) Payee or Vendor*
27) Comments or additional information.
27) Amount*
27) Receipt (PDF)*

Cancelof
28) Date of Expense*

MonthDayYear
Date
28) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
28) Account*
28) Payee or Vendor*
28) Comments or additional information.
28) Amount*
28) Receipt (PDF)*

Cancelof
29) Date of Expense*

MonthDayYear
Date
29) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
29) Account*
29) Payee or Vendor*
29) Comments or additional information.
29) Amount*
29) Receipt (PDF)*

Cancelof
30) Date of Expense*

MonthDayYear
Date
30) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
30) Account*
30) Payee or Vendor*
30) Comments or additional information.
30) Amount*
30) Receipt (PDF)*

Cancelof
31) Date of Expense*

MonthDayYear
Date
31) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
31) Account*
31) Payee or Vendor*
31) Comments or additional information.
31) Amount*
31) Receipt (PDF)*

Cancelof
32) Date of Expense*

MonthDayYear
Date
32) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
32) Account*
32) Payee or Vendor*
32) Comments or additional information.
32) Amount*
32) Receipt (PDF)*

Cancelof
33) Date of Expense*

MonthDayYear
Date
33) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
33) Account*
33) Payee or Vendor*
33) Comments or additional information.
33) Amount*
33) Receipt (PDF)*

Cancelof
34) Date of Expense*

MonthDayYear
Date
34) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
34) Account*
34) Payee or Vendor*
34) Comments or additional information.
34) Amount*
34) Receipt (PDF)*

Cancelof
35) Date of Expense*

MonthDayYear
Date
35) Class*
if unsure, reach out to your Chair, BOD Liaison, or Staff Liaison, and if unable to confirm, choose "unsure"
35) Account*
35) Payee or Vendor*
35) Comments or additional information.
35) Amount*
35) Receipt (PDF)*

Cancelof
Total From This Report
Should be Empty: