Expense Receipt Request

Expense Receipt Request

For Monthly Members
Please use the following form to request a expense reimbursement receipt for your records. Our current point of sale software has unfotunately elminated/discontinued the monthly charge auto email receipt feature so we have developed the following self serve option as a solution. The receipt will be generated and emailed instantly based on the information provided below. You will need to visit this form each month or as needed to request a receipt for your records. We do apologize for the inconvenience as we are work to update our current point of sale to provide a more of an automated solution.

If you have any questions, please email: Info@BuckeyeSuperWash.com or call 330.725.5273

Thank You,

The Buckeye Super Wash Team
Name

First NameLast Name
Email (where you want receipt sent)*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Transaction on Credit Card Statement to match your records:*

MonthDayYear
Date
Membership Level:*

#1 Buckeye +#2 Buckeye#3 Super#4 Basic
Are you Tax-Exempt?*

YesNo
Selected Membership Base Price:(emailed receipt will reflect tax or no tax based on exemption selection)
Please verify that you are human*
Tax
Total w/Tax:
Total w/o Tax:
Should be Empty: