STAFF Reimbursement Request

Reimbursement Request Form

For STAFF Use on expenses when ACCT company cards are not usable or available. This is NOT the form for CREDIT CARD expense reporting; This form will be submitted and result in a check being sent to you.
1. Please submit one reimbursement request form per trip/project.
2. 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.
3. 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
4. Choose the total number of additional expense lines you will need to complete your reimbursement request. You should have an expense line per receipt.
5. Enter the required information in the form fields.
6. Enter the Class for the expense. Your choices are: Events, Membership, Standards, Inspector Certification, Operation Accreditation, Vendor Accreditation, and Overhead.
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
Committee / Project / Purpose
Department who will review and Approve
Make Check payable to:
What are your claims?
Total number of other expense lines needed.
Miles driven in personal vehicle
Standard Mileage Claim (will calculate)
Date of Expense

MonthDayYear
Date
Class
if unsure reach out to the Executive Director or Board Chair
Account
Purpose
Guest
Payee or Vendor
Comments or additional information.
Amount
Receipt (PDF)

Cancelof
2) Date of Expense

MonthDayYear
Date
2) Class
if unsure reach out to the Executive Director or Board Chair
2) Account
2) Purpose
2) Guest
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 the Executive Director or Board Chair
3) Account
3) Purpose
3) Guest
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 the Executive Director or Board Chair
4) Account
4) Purpose
4) Guest
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 the Executive Director or Board Chair
5) Account
5) Purpose
5) Guest
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 the Executive Director or Board Chair
6) Account
6) Purpose
6) Guest
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 the Executive Director or Board Chair
7) Account
7) Purpose
7) Guest
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 the Executive Director or Board Chair
8) Account
8) Purpose
8) Guest
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 the Executive Director or Board Chair
9) Account
9) Purpose
9) Guest
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 the Executive Director or Board Chair
10) Account
10) Purpose
10) Guest
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 the Executive Director or Board Chair
11) Account
11) Purpose
11) Guest
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 the Executive Director or Board Chair
12) Account
12) Purpose
12) Guest
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 the Executive Director or Board Chair
13) Account
13) Purpose
13) Guest
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 the Executive Director or Board Chair
14) Account
14) Purpose
14) Guest
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 the Executive Director or Board Chair
15) Account
15) Purpose
15) Guest
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 the Executive Director or Board Chair
16) Account
16) Purpose
16) Guest
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 the Executive Director or Board Chair
17) Account
17) Purpose
17) Guest
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 the Executive Director or Board Chair
18) Account
18) Purpose
18) Guest
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 the Executive Director or Board Chair
19) Account
19) Purpose
19) Guest
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 the Executive Director or Board Chair
20) Account
20) Purpose
20) Guest
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 the Executive Director or Board Chair
21) Account
21) Purpose
21) Guest
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 the Executive Director or Board Chair
22) Account
22) Purpose
22) Guest
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 the Executive Director or Board Chair
23) Account
23) Purpose
23) Guest
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 the Executive Director or Board Chair
24) Account
24) Purpose
24) Guest
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 the Executive Director or Board Chair
25) Account
25) Purpose
25) Guest
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 the Executive Director or Board Chair
26) Account
26) Purpose
26) Guest
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 the Executive Director or Board Chair
27) Account
27) Purpose
27) Guest
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 the Executive Director or Board Chair
28) Account
28) Purpose
28) Guest
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 the Executive Director or Board Chair
29) Account
29) Purpose
29) Guest
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 the Executive Director or Board Chair
30) Account
30) Purpose
30) Guest
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 the Executive Director or Board Chair
31) Account
31) Purpose
31) Guest
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 the Executive Director or Board Chair
32) Account
32) Purpose
32) Guest
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 the Executive Director or Board Chair
33) Account
33) Purpose
33) Guest
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 the Executive Director or Board Chair
34) Account
34) Purpose
34) Guest
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 the Executive Director or Board Chair
35) Account
35) Purpose
35) Guest
35) Payee or Vendor
35) Comments or additional information.
35) Amount
35) Receipt (PDF)

Cancelof
Total From This Report
Should be Empty:

Reimbursement Request Form