Reimbursement Form

Reimbursement Form
Per FFC Bylaws:

Any FFC Coordinator or Board member can make or approve a purchase from their team’s budgeted FFC supplies as needed and submit a request for that expenditure to be reimbursed. Reimbursements may be requested by filling out the reimbursement form and providing physical or digital copies of receipts. Team members may make purchases as directed by their team Coordinator.

Reimbursements will be assessed and funds distributed at each monthly Board meeting. Priority of fund allocations will be directed first to expenditures necessary for the responsible operation of the Cooperative. Some examples of such expenditures would include but are not limited to building rental, insurance, and those subscriptions needed for website maintenance. If there are insufficient funds in the bank account, reimbursements will be delayed.

Urgent needs not included in a Team budget can be immediately granted by approval of two Coordinators/Board members for reimbursement from the General Emergency Fund.
Your Name :

First NameLast Name
Date :

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Email :
example@example.com
Make Check Payable to :
Reimbursement Details :
Total Charged to FFC :
Were any of the above purchases emergency purchases not included in any Team budget?
Which purchase(s) ? Please use same Description of Item from above :
Comments :
Will you provide physical or digital copies of receipts?
Digital Copy of the Receipt(s) :

Cancelof
I understand and agree that reimbursements will not be given until a physical copy of the receipt it provided.
Name of first Coordinator or Board member Approving Emergency Purchase Not Included in any Team Budget :

First NameLast Name
Signature of first Coordinator or Board member Approving Emergency Purchase Not Included in any Team Budget :
Name of second Coordinator or Board member Approving Emergency Purchase Not Included in any Team Budget :

First NameLast Name
Signature of second Coordinator or Board member Approving Emergency Purchase Not Included in any Team Budget :
I understand that reimbursements will be dispensed according to the procedure laid out above from the Bylaws and upon Board approval :
Should be Empty: