Arisia 2022 Expense Form

	A	B	C	D	E
1	Arisia, Inc. 2022 Convention Expense Reimbursement Form (Rev 12/2020)
2	Purchases made for Arisia, Inc. are not subject to Mass sales tax.
3	Mass State Sales Tax Exemption Number: 04-031143
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5	Payee Name:	Garret T. DeJong			PayPal or
6	Payee Email:	GarretDeJong@GMail.com			Check?
7	Phone #:	(+1) 860 888 2720			PayPal
8	Address:	31 Franklin St, Unit 2
9		Claremont	NH	3743
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11	Detailed list of expenses (add rows if necessary):
12	Receipt Date	Vendor/Source	Division/Area	Budget Category	Cost
13	01/06/2025	Amazon.com	Safety - SAF	SAF First Aid	5.98
14	1/6/2025	amazon.com	Safety - SAF	SAF First Aid	5.98
15	1/6/2025	amazon.com	Safety - SAF	SAF First Aid	5.98
16	1/6/2025	amazon.com	Safety - SAF	SAF First Aid	5.98
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21					$23.92
22	Receipt(s) must be included with this form. If receipts cannot be supplied, a memo detailing the reason must be approved by the ConChair Team.
23	Nothing in this form shall be considered a guarantee of payment. The Treasurer reserves the right to refuse incorrect, incomplete, or illegible forms.
24	Forward this completed form to your approver and cc your division.
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26	Approval - Division Head/ConChair Team
27	Approver Name:
28	Title:
29	Signature:
30	Date Approved:
31	Total Approved:	$
32	Forward this completed form to contreasurer@arisia.org.
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34	Approval - Convention Treasury Team
35	Approver Name:
36	Title:
37	Signature:
38	Date Approved:
39	Date Entered:
40	Account Used:
41	Pay Instrument:
42	#: