Texas Ministries Expense Reimbursement Form

Texas Ministries Expense Reimbursement
Use this form to request reimbursement for personal funds spent on behalf of Texas Ministries. Please note that all submissions are subject to final review and approval. Our office may reach out if we need additional details

Contact Information
Today's Date

YearMonthDay
4 digit year, 2 digit month, 2 digit dayTHIS BOX WILL AUTOPOPULATE.
Name

FIRST NAMELAST NAME
Phone Number
PLEASE ENTER A VALID PHONE NUMBER.Format: (000) 000-0000.
Email
example@example.com
Address

STREET ADDRESS

STREET ADDRESS LINE 2

CITYSTATE/PROVINCE

POSTAL/ZIP CODE

Expense Details
Please select the expense category to be charged.
If you selected 'Other,' please describe your expense below.
If you selected 'Unsure,' please describe your expense below.
Do any of your expense reimbursements fall into the following categories? Check all that apply.
Meals Reimbursement
Total Meals Reimbursement Expense:
PLEASE ENTER TOTAL COST OF MEALS TO BE REIMBURSED.
For any meal expenses, please provide the following information: restaurant name, date of the meal, names of guests whose meals were covered and the business purpose of the meal.
Personal Auto Mileage
If you traveled by personal auto, please enter you total mileage in the PERSONAL AUTO MILEAGE box below. The reimbursed mileage amount accounts for fuel, oil, tolls, vehicle insurance, and depreciation.

When you type your mileage into the PERSONAL AUTO MILEAGE box, the reimbursment amount will auto-populate in the expenses chart below.
Personal Auto Mileage
PLEASE ENTER MILEAGE AS A WHOLE NUMBER (NO DECIMALS).
Expenses Chart

Enter all other (non-mileage related) expenses into the chart below. Receipts are required for reimbursement.

Rows	$ Amount
Fare (Plane, Bus, Train)
Lodging
Meals
Parking
Personal Auto Mileage @ $.76 per mile
Rental Car
Taxi/Rideshare
Tolls (Car Rental Only)
Various/Other

Receipts
Receipts are required for reimbursement, with the exception of personal auto mileage. Please upload all your receipts below.
Receipt Uploader

Cancelof
Should be Empty:

Texas Ministries Expense Reimbursement