HG: REIMBURSEMENT

HIGHER GROUND LLC

15821 VENTURA BLVD #370 ENCINO CA 91436
REIMBURSEMENT
Project Name
Approver
"Your Name" and all requested information is for whoever is being reimbursed.

If you are filling this out for someone else, please ensure the information is for the payee. You may put your email address in the "Contact Email" field if you wish to receive the notifications or be the point person for any followup.
Your Name
Contact Email
Department
Please ensure the W9 is a legible PDF. We are required to have this on file but personal reimbursements will not be considered taxable income if there are qualified receipts. Blank W9 form can be found here: https://www.irs.gov/pub/irs-pdf/fw9.pdf

For payment details, please upload the Vendor Payment Acceptance Form (USD).
Upload Vendor W9 + Vendor Payment Acceptance Form (USD)

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How many receipts do you have?
EXPENSE DETAIL

Please line-item out each receipt. Description will be "MMDD:ITEM:MERCHANT" i.e. 0411:COFFEE:STARBUCKS.
Total Amount Due
This will auto-calculate.
If you have more than five receipts, please fill out the SPREADSHEET (excel, google sheets, numbers) expense form and upload.
Total Amount Due
Upload Spreadsheet Expense Form:

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Upload Receipts:

Receipts must be legible with the merchant, line items, date, and total.
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Additional Comments?
Should be Empty:

REIMBURSEMENT