BRSLL Expense Request & Deposit Forms - new logo.xlsx
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BRSLL EXPENSE REIMBURSEMENT FORM
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Request Date:
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Submitter's name (First & Last):
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Name of person check is to be made out to:
(Provide if it is differerent than submitter):
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Payee Address Information
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#Date of expenseExpense Item Description
(Vendor & type of expense)
PurposeBudget Category
(eg. Fields, Equipment, etc)
Dollar Amount
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11/5/2010 Example: KinkosRegistration FlyersLeague$100.00
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*** Please attach your receipts. ***
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Advanced Dollars:
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Date of advanced check:
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Check number:
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Total Net Amount Due:
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Comments:
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