Reimbursement Form
Date
MM
/
DD
/
YYYY
Name
person completing form
Your answer
Committee / Position
Your answer
Phone Number
best contact number
Your answer
Email
Your answer
Amount Requested
Your answer
Date Funds Needed
if applicable
MM
/
DD
/
YYYY
Payee
make this check payable to
Your answer
Payee Address
Make Check Address to
Your answer
Is check to be mailed directly to Payee at the above address?
Required
If "NO", please provide instructions
example : "leave in office (which box?)" or "mail to you (provide address)"
Your answer
Explanation of Request
if necessary
Your answer
SEND US YOUR DOCUMENTS
Please scan & email all documents regarding this request to TREASURER@INGLESIDEPTO.COM. The store name, date, and totals MUST be readable. *JPEG & PDF okay* Okay to FWD online receipts*

- receipts
- invoices
- order forms
- registration forms

Your reimbursement cannot be processed until the receipts are received.

SEND US YOUR DOCUMENTS
Please scan & email all documents regarding this request to TREASURER@INGLESIDEPTO.COM. The store name, date, and totals MUST be readable. *JPEG & PDF okay* Okay to FWD online receipts*

- receipts
- invoices
- order forms
- registration forms

Your reimbursement cannot be processed until the receipts are received.

CANNOT SCAN DOCUMENTS?
1) Drop your receipts in the TREASURER MAILBOX in the INGLESIDE OFFICE in a sealed envelope with your name on it.
2) Email the Treasurer at TREASURER@INGLESIDEPTO.COM when completed.

Your reimbursement cannot be processed until the receipts are received.

IF YOUR REQUEST EXCEEDS THE BUDGETED AMOUNT, THE PTO EXEC BOARD MUST VOTE & APPROVE PRIOR TO REIMBURSEMENT.
ALL REQUESTS MUST BE APPROVED BY COMMITTEE CHAIRS BEFORE REIMBURSEMENT.
SIGN HERE
by signing here, you are affirming that all information above is true.
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