Expense Reimbursement - Draper Suncrest Stake

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2					Check Number:	_____________
3					Check Date:	_____________
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5	Expense Reimbursement Form
6	Draper Suncrest Stake
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8	Budget Category: (select from below)
9	Responsible Organization:
10	Requested By:
11	Make Check Payble to:
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13	(if not a member of the stake: Street Address
14	City, State, Zip)
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16	Expenditures (receipts must be attached to this form)
17	Item Description	Activity / Purpose		Item Cost	Sales Tax	Total
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25			TOTALS:	$	$	$
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27	Authorization for Expenditures:
28	Organization Head
29		Printed Name			Signature
30	Stake Presidency
31		Printed Name			Signature
32	Stake Financial Clerk
33		Printed Name			Signature
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36	Budget Categories:
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45	Instructions:
46	For reimbursement of approved expenditures, please complete this form including payable to, description, dates and organization approvals. Please break out the sales tax portion of each receipt.
47	Please attach receipts on a separate 8.5 x 11 sheet of paper (taped). Please circle or highlight the totals on the receipts that match the amounts listed on this form. Please place the completed form in
48	the Finance box in the Stake Clerk's Office or email it to davidcjoneshome@gmail.com
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