Expense Reimbursement Form

From the Policies and Procedures (2/2023 version):

For events that LWVWA and LWVWA Education Fund Board members are expected to attend, such as the LWVWA convention and council, and at least one of the LWVWA Action Workshops or lobby events each year), the cost of registration, travel, and lodging (based on one-half of the cost of double occupancy, mid-range accommodation) may be reimbursed. Meals outside of those included in the event agenda are not reimbursable. Per-member reimbursement amounts (for mileage, registration, and lodging) for Board member attendance at the LWVWA council and convention shall be established when the budget for the respective event is adopted. Board member costs for mileage, registration and lodging should be factored into the total cost of the Board expenses budget. This policy also extends to LWVWA nominated officers and directors.

LWVWA Board members selected as delegates to represent the state League at the LWVUS convention or council shall be reimbursed for the costs of conference registration fees, lodging (based on one-half of the cost of double occupancy, mid-range accommodation), transportation, and other expenses, as preapproved in writing. Delegates to the LWVUS conference or council selected by the LWVWA Board must request reimbursement for all or part of the expenses for attending the LWVUS convention and/or council on forms established for such reimbursement by the respective 501(c)(3) and 501(c)(4) treasurers. Delegate(s) are responsible for a report back to the LWVWA/LWVWA Education Fund Boards of Directors. LWVWA Board members may also be reimbursed for a share or all of the cost of registration, travel, and lodging (based on one-half of the cost of double occupancy, mid-range accommodation) related to short-term activities, workshops/seminars/educational conferences they attend corresponding to their respective roles and issue areas, in order to gain more knowledge, to the extent that there is budget available. Expenses must be planned for and included in the budget.

LWVWA Board members may be reimbursed partially ($.14/mile) for the cost of travel to the Board meeting (including mileage and lodging based on one-half of the cost of double occupancy, mid-range accommodation). Reimbursements for the Board of Directors meetings is made through a request to the 501(c)(3) or 501(c)(4) Treasurer (form on the LWVWA SharePoint site). The LWVWA/Education Fund Boards may specify other allowable expenses prior to attendance at event/meeting. Carpooling is encouraged.

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState

Zip Code

Is this a c3 (Ed Fund) or a c4 expense? If you have expenses for both please complete separate forms for each entity.

Generally c-4 writes the checks for board meeting and convention travel and c-3 for state and national councils, and treasurers figure it out. In terms of automatic calculation, remember that for most travel the policies is .14 per mile and 40.00 per night based on double occupancy unless previously approved. For councils and conventions the amounts are based on double occupancy for rooms at the venue.

What types of expenses do you have?

Expense Details

Registration Fee: Accounting Category/Event

Registration Fee: Actual Costs

Airfare: Accounting Category/Event

Airfare: Actual Costs

Hotel (based on double): Accounting Category/Event

Hotel (based on double): Actual Costs

Mileage ($0.14 x___miles): Accounting Category/Event

Mileage: Total Mileage

Mileage: Actual Costs (automatically calculated)

Rental Car/Taxi/Shuttle: Accounting Category/Event

Rental Car/Taxi/Shuttle: Actual Costs

Parking: Accounting Category/Event

Parking: Actual Costs

Printing: Accounting Category/Event

Printing: Actual Costs

Postage: Accounting Category/Event

Postage: Actual Costs

Supplies (Office): Accounting Category/Event

Supplies (Office): Actual Costs

Other (Item 1): Accounting Category/Event

Other (Item 1): Description of Expense

Other (Item 1): Actual Costs

Other (Item 2): Accounting Category/Event

Other (Item 2): Description of Expense

Other (Item 2): Actual Costs

Other (Item 3): Accounting Category/Event

Other (Item 3): Description of Expense

Other (Item 3): Actual Costs

Other (Item 4): Accounting Category/Event

Other (Item 4): Description of Expense

Other (Item 4): Actual Costs

Total Expenses (automatically calculated)

Amount of Cash Advance, If You Received One

Net Expense

This is the total amount that you spent.

If you want any of this to be considered an in-kind donation to LWVWA, enter that amount here:

Total Requested

This is the total amount for which are you asking to be reimbursed.

Comments:

Upload Scans, Photos, or PDFs of Your Receipts

Browse Files