Reimbursement Request or Expense Authorization Form



Reimbursement Request or Expense Authorization Form

Attach all receipts to this form

Requestor’s name: _________________________________Payable to: __________________

Description of expense: __________________________Amount: $________Tax: $________

Budget or fast offering category: _________________________Organization: ____________

This request is A reimbursement An advance payment

Requestor’s signature: _________________________________ Date: ___________________

Organization president’s signature: __________________________Date: _______________

Bishop’s signature: ____________________________________ Date: ___________________

Reimbursement Request or Expense Authorization Form

Attach all receipts to this form

Requestor’s name: _________________________________Payable to: __________________

Description of expense: __________________________Amount: $________Tax: $________

Budget or fast offering category: _________________________Organization: ____________

This request is A reimbursement An advance payment

Requestor’s signature: _________________________________ Date: ___________________

Organization president’s signature: __________________________Date: _______________

Bishop’s signature: ____________________________________ Date: ___________________

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