Payment Voucher Form 1b

PAYMENT VOUCHER FORM

Minneapolis-St. Paul Alumnae Chapter | Delta Sigma Theta Sorority, Inc.
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Fiscal Period*
Select the Fiscal Year in which expenses were incurred.
Now

MonthDayYear
Date
Request Date*

MonthDayYear
Date

Name*

First NameLast Name
Email*
example@example.com
Are you the Committee Chair/Co-Chair or Officer? If you select "Yes," the voucher will be routed directly to the President after you submit it. The Committee Chair/Co-Chair approval step will be skipped.*

YesNo

List each expense item separately. SCANNED, DATED receipts (or invoices) must be attached. Receipts CANNOT include personal expenses and must match the amount requested. Receipts must be submitted within 30 days of the PURCHASE DATE indicated on the receipt.

Expenses: *

Total $
Receipt(s) and/or Invoice(s)

Upload receipt(s) or invoice(s) here. Up to 5 files are allowed - pdf, doc, docx, zip, jpg, jpeg, png, heic. Please limit the total size to 5MB.
Cancelof
Take Photo of Receipt (Optional)-Please limit to 5MB total size.
THERE ARE NO RECEIPTS ATTACHED. YOUR VOUCHER WILL NOT BE PROCESSED WITHOUT SUPPORTING DOCUMENTATION.
COMMITTEE TO BE CHARGED (sub-committees are listed under standing committee)
Select Committee 1*
Calculated Email Address 1
Suggested Committee Chair email address based on committee selection. You must confirm the correct address below by typing it in TWICE.
Confirm Email Address of Committee Chair 1*

Confirmation Emailexample@example.com
Is the Committee to be charged a Subcommittee? If you select "Yes," the primary Committee Chair must be added as secondary approver below.*

YesNo

Select Committee 2 (if applicable)
Enter a second committee to approve this voucher, if applicable.
Calculated Email Address 2
Suggested Committee Chair email address based on committee selection. You must confirm the correct email address below.
Confirm Email Address of Committee Chair 2

Confirmation Emailexample@example.com
Charge Split Note
Enter information about how expenses are to be split between the two committees (if applicable)

Requester