Credit Card Transactions Documentation

This form is to document transactions made using a Niagara Swimming owned credit, charge, or debit card.

DO NOT use this form for reimbursement requests.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Transactions

Rows	Date	Merchant	Total Cost	Budget Line	Receipt Attached
1
2
3
4
5
6
7
8
9
10

Purchased Items Total

Calculated Field

Were any transactions greater than $250?

Expenses Greater than $250

The Niagara Policy and Procedures requires multiple bids for expenses greater than $250. List all transactions greater than $250 and provide an explanation demonstrating compliance with this policy.

For all receipts, be sure it is a receipt and not just a credit card receipt. The receipt must show what was purchased or paid for.

Attach all receipts. Combined to a single pdf preferred.

Check this box if you are unable to attach a receipt for one or more transactions above.

I certify that I made the purchase(s) listed above for official Niagara Swimming business. I have made a good-faith effort to obtain a copy of the itemized receipt from the vendor but was unable to do so. I confirm that no alcohol, personal, or non-allowable items were included in this/these charge(s).

All instances of missing receipts are reviewed by the Treasurer and may result in further review, suspension of credit card use, and if necessary request for reimbursement of funds to Niagara Swimming.

Reason for missing receipt:

Please explain why the receipt(s) could not be obtained.

Further Explanation

Please provide any other details that may be helpful in processing your request. If asked for more information by the approver, please provide answers here.

By signing below, you attest that all information provided in your documentation is true and accurate. In addition, your request is in accordance with the Bylaws and Policies and Procedures of Niagara Swimming, Inc.

Signature

Name of Signer

First NameLast Name

Credit Card Transactions Documentation

Card Holder

Receipts