LVF Expense Reimbursement Form
Name
*
First Name
Last Name
E-mail
*
Your E-mail Address
Ministry Department for Expenses
*
Please Select
Facilities
Hospitality
Inreach
Outreach
Pastoral/Admin
Sabbath School
Worship
PLEASE USE ONE FORM PER MINISTRY. If your receipt contains expenses for different ministries, please submit a separate form for each ministry.
Are you the Director of this ministry?
*
Yes
No
Purpose of Expenses
*
Expense Details
NOTE: Expenses over $300 must be board-approved
Itemized Expenses:
*
Rows
Purchase Date
Store/Source
Description of Items
Category/Event
Cost ($)
Receipt #1
#2
#3
#4
#5
#6
Total Expenses
Attach Receipt(s)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
How would you like to receive your reimbursement funds?
*
Please Select
Check
Venmo
Zelle
Recipient info according to reimbursement method selected
(e.g. exact name written on check / Venmo tag / Zelle phone number or email)
Comments:
Your Signature
*
Treasurer's Email
example@example.com
Treasurer Assistant's Email
example@example.com
LVF Treasury Email
example@example.com
Print Form
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