Request for Spending & Reimbursement

Request for Spending & Reimbursement
Unitarian Universalist Community of the Mountains
Part I. Spending Approval
Instructions:
All information must be completed and comply with UUCM financial policies. The Treasurer may reject an incomplete form.

The 'Requested By' is the person spending the money and the 'Approved By' is the person authorized to spend the budget line item. If the 'Requested By' is authorized to spend the budget line item, no additional approval is necessary.

Part I. Spending Approval

Total Expense/Reimbursement ($):
Requested By (if requester has spending authority, skip and complete "Approved By"

First NameLast Name
Signature:
Date signed by requester:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Part II. Reimbursement or Payment
How is payment to be made?
Choose Credit Card Account:
Payee Name (REQUIRED):

First NameLast Name
Payee Address (REQUIRED):

Street Address

Street Address Line 2

CityState

Zip Code
Payee Phone No. (REQUIRED):
Format: (000) 000-0000.
Date check is needed:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Upload photo/PDF of receipts:

Cancelof
Date submitted:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: