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Inspiring Connections Outdoors (Reno ICO)
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Reimbursement Form
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ICO Group Name:
Sierra Club Reno ICO
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Brief Description of Activity:
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Requested By:
Date:
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Phone:Email:
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If Check Payable To:
No - Pay by Check
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Address:If you prefer to be paid by Zelle, select that option from above and make sure your phone number or email address is registered with Zelle
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City, State, Zip:
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Expense & Receipt Information:
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1. Organize your receipts by type and then number them (1, 2, 3, etc.)
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2. Enter your receipt number and expense amounts below. See Examples below.
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3. Totals will automatically populate the cover sheet.
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Date of Expense:Brief Description of Expense:Receipt #Equipment & SuppliesFees & PermitsFoodOtherTransportationTraining
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10/28/2022Food shop at WinCo1 25.50
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11/1/2022Vehicle Rental at Enterprise2 450.75
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Above is for Example only
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Insert new rows ABOVE this line only if needed
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Totals: - - - - - -
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