Claim for Refund of Personal Expenses for Approved Club Expenses

Claim for Refund of Personal Expenses for Approved Club Expenses

This form is used to claim personal expenses relating to club purchases (example: Water, Catering supplies, Unexpected Needs, Etc).
What you will need to complete this form:
* Scans or photos of all receipts and invoices
* Photo of the actual purchased items
Name of person submitting this Refund Request:

First NameLast Name
Itemised Claim. Please Itemise your claim, with cost for each item. EG: 1L Bottled Water x12, $16.00
Upload copies of Receipts and Invoices here. Please also include a photo of items purchased:

Cancelof
Bank Account details for Payment:
NOTE: After submission, your request will be reviewed by the committee. The committee may request additional information or justification before approving your refund.
The committee reserves the right to refuse refund, or provide only partial refund if, after review, the committee deem the expense excessive, or innapropriate for the group.

DECLARATION:
I declare the funds claimed were used for the items as described above, were genuinely purchased for club use, and are reflected in receipts and invoices attached to this form.
I have also attached photos of the purchased items as part of this submission.
Signature
Should be Empty: