Expense Reimbursement/Request for Funds

Published by
Darlene Sarkela

05-17-17

Please fill out the form below to be reimbursed, or to request a transfer between church accounts.

All expenses must be approved by the committee chair, team leader, or reserve fund manager. This can be done by emailing the Administrator. Requests need to be accompanied by backup, such as a receipt, invoice or order form (these can be scanned and emailed to the church office, or uploaded below).

Choose One:

Check Request
Petty Cash
Transfer Request

Check Payable/Petty Cash/Transfer to:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Item #1 - description and amount

Item #2 - description and amount

Item #3 - description and amount

Total amount

Note on memo line of check (optional)

Charge to Budget Account or Reserve Fund:

Disposition of check:

To be picked up by requesting party
To be mailed out by church office

Any special instructions?

Requested by:

Please choose one:

I am the fund manager and approve this expense
I have requested approval from the fund manager

File Upload

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