PAYMENT REQUESTS
Trustees of the Synod of the RPCNA 7408 Penn Ave, Pittsburgh, PA 15208 412-731-1177 controller@rpcna.org
2026 Expense Reimbursements and Payment Requests
For Travel and Non-Travel for Boards and Synod Committees (not for the annual Synod meeting)
Payee Name
*
Address
Email
*
Date of Expense or End Date of Travel
*
/
Month
/
Day
Year
Type of Expense
*
Please Select
Board Meeting
Committee Meeting
Conference
Fraternal Delegate
Mission Field
Mission Short Term
OTHER
Other Information
(PLEASE DO NOT USE THIS FORM FOR SYNOD MEETING TRAVEL REIMBURSEMENT)
Board
SELECT AN ITEM IF APPLICABLE
Benefits
Education+ Publications
Geneva Corporators
Global Missions
Home Missions
Seminary
Trustees of Synod
or Committee of Synod
SELECT AN ITEM IF APPLICABLE
Business of Synod
CASA
Chaplain
Church History/Archives
EA Commission
Finance
Global Alliance
Graduate Study
Interchurch
Intl Conference
Judicial
Vital Churches
Youth Ministries
Other Committee
Other Information
Mission Field
SELECT AN ITEM IF APPLICABLE
Asia - Central
Asia - South
Pakistan 1
South Sudan
Thailand
Other Countries
Mileage:
Miles driven
for 2026 only
Mileage
IRS Mileage Rate: $.725/mile
Per Diem (in lieu of parking, tolls, meals):
Days for per diem
Per Diem
$40/day
Actual parking, tolls, meals (in lieu of per diem):
Parking
(Only If Per Diem Is Not Used)
Tolls
(Only If Per Diem Is Not Used)
Meals
(Only If Per Diem Is Not Used)
Total Parking, Tolls, Meals
Other Travel:
Airfare
Rental Car
Taxi / Uber
Other Expenses:
All Other Expenses
All other travel or non-travel expenses
Description of All Other Expenses
Total Payment Request:
Payment Method (Note: this is an encryted form)
Select Check or Electronic Funds Transfer
*
Check
EFT
Bank Routing # for EFT
9 digits without dashes
Bank Account # for EFT
Numbers only without dashes
Attach Required Receipts & Additional Information
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