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?*

Miles in personal vehicle (use for mileage reimbursement when a personal vehicle is used)Other line items (other travel, etc.)
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
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Reimbursement Request Form