REGEN EXPENSE FORM
Please use this form to submit your Payment Request or Reimbursement Claim. For non-standard items, there may be a slight processing delay to confirm authorisation.
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Payment Type
*
Please Select
Member (Reimbursement)
Supplier (Invoice)
Other (Provide details below)
(Who are we paying?)
Regen Service
*
Please Select
General / Multiple
Morning Service
Mandarin Service
Night Church
The Way Church Pakenham
FTG Church Plant
(Who pays for this?)
Expense Area
*
Meals & Hospitality
Church Services & Events
Staff Team & Administration
Building & Maintenance
Other
EXPENSE DETAILS
Please provide details of the Expense and related attachment(s) below, and note any differences between the provided receipts and the Payment Amount (e.g. lost receipt, partial payment, non-Regen items, transaction fees).
Summary of expense
*
(Where, when, and why was this expense incurred?)
Supporting Attachment(s)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Number of Receipts
(How many receipts are you attaching?)
Payment Amount AUD
*
(What is the total amount to be paid?)
GST on Receipts?
*
Yes, GST listed
No GST or GST-Free
Unsure
PAYMENT INSTRUCTIONS
Please confirm the account details for payment. Payments are normally processed within 14 business days of the form submission.
Destination Bank Account
*
Please Select
Bank Account - on file
Bank Account - new PayID
Bank Account - new BSB/ACC
Bank Account Name
*
PayID Reference
Account BSB
Account Number
DECLARATION
By signing and submitting this form, you declare that the information provided is true and complete.
Signature
*
Submission Date (today)
-
Day
-
Month
Year
Date
Submit
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