CERTIFICATION FOR MISSING/UNATTAINABLE RECEIPT
FOR TREASURERS USE ONLY: Check No.__________ Amount $__________ Date ______________ Approved by: Board Motion_____ Budget___________ Other____________ |
COMPLETE INFORMATION, AND MAIL OR GIVE TO TREASURER
Use this form to report on payment or reimbursement for expenses incurred and the original itemized receipts is not available or missing.
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AMOUNT PAID | $ |
□ Check □ Check □ Other | |
PAYMENT MADE TO | |
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MEMBER NAME | |
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REASON FOR MISSING OR UNATTAINABILITY |
SIGNATURE OF MEMBER | |
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APPROVAL | |
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