Reimbursement Form 7.25.xlsx

	A	D	E	G	H	I	K
1	TWCP PTO
2	Reimbursement & Check Request
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4	Attach receipts and/or invoices. Sales Tax will not be reimbursed
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6	Check Requestor:			Date:
7	Position:			Phone:
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9	Reason for Check:
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13	Payable to:				Amount:
14	Address of Payee:
15	Address of Payee:
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17	Place of Purchase	Date				Cost
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25					Total:
26					must match check amount
27	Budget Category					Amount
28	(If your invoice reflects more than one category, please identify each one and the amount to be deducted.)					Amount
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32					Total:
33						must match check amount
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35	1st Check Signer:				Date:
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37	2nd Check Signer:				Date:
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39	For Treasurer's Use Only
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41	Date Received:	Check #			Date:
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43	Within Budget		Approved by Meeting (date):
44							Updated 7/25
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