Copy of SPS Expense Reimbursement Form
 Share
The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

 
View only
 
 
Still loading...
ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
Go to File, Download to your Computer, Open Excel, Edit this File, and Send This along with Receipts PDFs. Send all attachments to bookkeeping@summitps.org.
2
Summit Public Schools Expense Reimbursement Request
3
IMPORTANT: Do not print this form to complete by hand as there are often calculation errors and illegibility issues. Complete this form by typing your information into the template. Then get the signatures of the director before submitting.
4
Your Name:
Grade Level (Required for Study Trip expenses)
_______________
5
6
Mailing Address :
Your Contact Phone # and email (please write below)
7
Phone:
8
School/Team Name:
Email:
9
10
11
Date Code (Leave Blank)Company/Business NameNote/Nature of Expense (VERY IMPORTANT: Provide all details for the event name, activity, or identifying project related to the expense)Amount
12
13
14
15
16
17
18
19
20
21
22
23
Checklist - Mark X here
Total (Leave E30 blank - auto-calculates) :
0.00
24
I have signed the requester (You are the requester) signature field below and the director / executive director has signed also.
25
I have provided complete details and activity names for each expense listed here.
26
I have provided a separate receipt (and if applicable: packing slips, hotel stay confirmation slips, etc.) for each expense listed here. If I have listed 5 expenses, I have submitted 5 separate receipts. Exceptions include San Jose and pre-established mileage rules.
27
IMPORTANT: PRIOR TO SIGNING OFF ON THIS DEPOSIT, PLEASE READ AND FOLLOW THE CHECKLIST ABOVE. THIS FORM IS NOT COMPLETE WITHOUT MARKING X ON EACH ITEM TO CONFIRM COMPLIANCE.
28
29
Requester's Signature: ___________________________________
30
31
Director's PRINT NAME and Signature: _____________________________________
Date: __________________________________________________
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Loading...
 
 
 
Request Form