26-27 Section VI Chairperson & Staff Expenses Reimbursement Request Form

Required

Required criteria to request reimbursement:

Form and required criteria must be completed to be considered for approval. One form per event is required.
Expense claims detailed on this form are only to be inclusive of submitting individual. Receipts should be CLEARLY marked if they include multiple guest charges. Reimbursement for YOUR expenses to cover a co-chair must also be CLEARLY indicated marked on receipts.
Receipts are required for each itemized expense (*alcohol cannot be included on receipts and credit card statements are not acceptable).
Toll documentation is required for toll reimbursement (highlight tolls only applicable to claim)
Google directions, MapQuest or another legitimate mapping service documentation is required for mileage reimbursement.
Note: Mileage is paid based upon current year IRS rate.

Daterequired

Must contain a date in MM/DD/YYYY format

Namerequired

First Name

Last Name

Email Addressrequired

Address (to mail reimbursement check)required

Eventrequired

Event Daterequired

Event Locationrequired

I am requesting reimbursement for mealsrequired

Total amount claiming for mealsrequired

Did you clearly mark your expenses and indicate any co-chair meals (if applicable) you paid for on multiple guest checks? (Y/N)required

Upload all meal receiptsrequired

Attach up to 5 files with a maximum size of 20MB

No file chosen

I am requesting reimbursement for tolls.required

Total amount claiming for tollsrequired

Upload Tolls Receipt/Statement (mark tolls related to claim)required

Attach up to 5 files with a maximum size of 20MB

No file chosen

I am requesting reimbursement for mileagerequired

Total number of miles being claimed (number must match total miles of all uploaded mapping service documentation)required

Must contain only numbers

If you are requesting mileage between venue and hotel, indicate how many trips total, back and forth (or type N/A)required

Upload all mapping service documentationrequired

Attach up to 5 files with a maximum size of 20MB

No file chosen

Other: I am requesting reimbursement for an uncategorized itemrequired

Description of uncategorized itemrequired

Total amount claiming for uncategorized itemrequired

Upload receipt for uncategorized itemrequired

Attach up to 3 files with a maximum size of 20MB

No file chosen

My typed named serves as my signature and all claims and supporting documentation / receipts are accurate to the best of my knowledge.required

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