UAND Payment Request

UAND Payment Request
For UAND members or others who need payment or to be reimbursed from UAND.

Complete the information below. The UAND Treasurer will be notified of your request and will forward payment to you within 2 weeks of your request.
Person/Company/Entity to be Paid*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number

Area CodePhone Number
Expense

(If more than one expense is to be reimbursed, upload a spreadsheet showing all of the information below for each expense).
Date of Expense*

MonthDayYear
Date
Expense Amount*
Expense Purpose*
Pillar to be Charged*
Advocacy Fund to be Charged*
Education Fund to be Charged*
Marketing Fund to be Charged*
Membership Fund to be Charged*
Operations Fund to be Charged*
Comments
Upload Pertinent Files

Browse Files
Include scanned copies of receipts. Upload spreadsheet for multiple expenses and include scanned receipts. Cancelof
Should be Empty:

Expense