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Credit/Debit Expense Form for SRM
This form is used for reporting the expenses for SRM using your Credit/Debit ministry card. You can only report expenses for ONE Card at a time and for ONE MONTH at a time. Please provide receipts for each transaction.
Your Name
*
First Name
Last Name
Card Info
*
Credit Card
Debit Card
Account Type
Bank (Amex, Chase, Citi)
Name on the Card
Last 4 digits of the card #
Team Name
If applicable
Person whom you received the card from?
if not applicable leave blank
Mission's Location where the funds were used
*
Your Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Your Phone Number
*
E-mail
*
Your E-mail Address
Expense Detail
Only list the expenses for the month you select below! Use a separate form for previous/following month.
Month Date
*
Expenses List
*
Purchase Date
mm/dd/yyyy
Ministry Category
(Kids ministry, Youth, Refugees)
Product/Service Description
(Gas, Food, Travel, Supplies)
Cost Local
Currency
COST
in USD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Additional Expenses List
Purchase Date
mm/dd/yyyy
Ministry Category
(Kids ministry, Youth, Refugees)
Product/Service Description
(Gas, Food, Travel, Supplies)
Cost Local
Currency
COST
in USD
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
52
53
54
55
56
57
58
59
60
71
Total from Expense list in Foreign Currency (only use if expanses are not USD)
Total from Expense list in USD
Upload any Receipts Here
*
Browse Files
Drag and drop files here
Choose a file
To scan your receipts open notes app on your iPhone, click on camera icon, select scan documents and upload all your receipts. Please try to scan multiple receipts at once. If you don't have an iPhone visit apple.com NOTE: Your iPhone purchase does not qualify for a ministry expense at this time.
Cancel
of
I certify
*
I certify that all information and attached receipts have been used solely for the purpose of SRM and not for personal use. I acknowledge that I have used THE FEAR of THE LORD in making SRM transactions. I understand that by providing false information, I may be liable to repay with interest. I promise that all information entered in this form is valid and true.
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