Lodgers Tax Funds Reimbursement Form
THE FOLLOWING MUST BE SUBMITTED WITH THIS FORM:
• AN ITEMIZED LIST OF ELIGIBLE EXPENSES. • COPIES OF PAID RECEIPTS AND EVENT BUDGET. • COPIES OF ALL PROMOTIONAL MATERIALS AND ANY PRESS COVERAGE.
EVENT DETAILS AND CONTACT INFORMATION
Event Name
*
Event Start Date
*
-
Month
-
Day
Year
Date
Event End Date
*
-
Month
-
Day
Year
Date
Organization Name
*
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EVENT REPORT
EVENT OUTCOME: Please provide a brief description of how the event turned out.
*
EVENT ADVERTISING: Please attach copies of all promotional materials and press coverage.
*
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What was the estimated visitor attendance?
*
How was visitor attendance measured?
*
REQUIRED DOCUMENTATION
RECEIPTS for eligible expenses and proof of payment
*
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FINAL COMMENTS
Do you plan to request Lodgers Tax funds again next year?
Please Select
Yes
No
Don't know yet.
Additional remarks for the Lodgers Tax committee.
SIGNATURE
Signature
*
Today's Date
-
Month
-
Day
Year
Date
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