Attach Receipt(s) Here

PTA of MS54

PAYMENT OR REIMBURSEMENT FORM

DATE:_______________________________

PAY TO THE ORDER OF:_____________________________________________

COMMITTEE/EVENT:________________________________________________

DESCRIPTION OF ITEMS:_____________________________________________

________________________________________________________________

________________________________________________________________

AMOUNT $__________________________

 For Auction Expenses only:

AUCTION CHAIR APPROVAL:     ________________________________________

1.        Please fill out this form completely.

2.         Receipts, invoices, or contracts must be attached to this form.

3.        Give this form with attached documentation to PTA Treasurer or to Anne Pejovich, MS54 Parent Coordinator.