NEWGF173-14b(F380) Reimbursement, Payment, or Check Request (Squadron)

To complete this form online, you will need the name, email address, CAPID, and duty position of two approving authorities.

You need two approving authorities for all payments. Generally, this will be a unit commander or deputy and a second member of the unit finance committee. Check with your unit commander or finance officer for information.
Date of Request*

MonthDayYear
Date
Requestor Name*

First NameLast Name
Requestor Grade*
Requestor CAPID*
Requestor Email*
example@example.com
Requestor Title*
Requestor Home Unit*
Bill to Unit*
Date Check Needed by:

MonthDayYear
Date
ISSUE CHECK TO:
Payee or Company Name*

First NameLast Name OR Company Name
Payee Grade*
Payee CAPID (If Applicable)
Payee Address*

Address

Street Address Line 2

CityState

Postal / Zip Code
Zip Code*
Only use 5 digits
Payee Email Address*
example@example.com
Payee Phone Number*
Miscellaneous Information
Itemized Expense 1 Description*
Itemized Expense 1 Account Number*
Account Numbers IAW CAPR 17301
Itemized Expense Amount 1*
Itemized Expense 2 Description
Itemized Expense 2 Account Number
Account Numbers IAW CAPR 17301
Itemized Expense Amount 2
Itemized Expense 3 Description
Itemized Expense 3 Account Number
Account Numbers IAW CAPR 17301
Itemized Expense Amount 3
Calculation
Upload up to three receipts. You may take pictures with your phone as well.

pdf, doc, docx, xls, xlsx, csv, txt, rtf, jpg, jpeg, png, gif
Cancelof
Requestor Signature*

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To complete online, you must fill in the following information. Otherwise, you need to manually fill out the form, print it, and submit it.

You need two approving authorities for all payments. Generally, this will be a unit commander or deputy and a second member of the unit finance committee. Check with your unit commander or finance officer for information.
Name of First Approving Authority*

First NameLast Name
Email Address of First Approving Authority*
example@example.com
CAP ID Of First Approving Authority*
Title of First Approving Authority*
Name of Second Approving Authority*

First NameLast Name
Email Address of Second Approving Authority*
example@example.com
CAP ID Of Second Approving Authority*
Title of Second Approving Authority*
Should be Empty:

To complete this form online, you will need the name, email address, CAPID, and duty position of two approving authorities.

ISSUE CHECK TO:

To complete online, you must fill in the following information. Otherwise, you need to manually fill out the form, print it, and submit it.