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FRANK BLACK MIDDLE SCHOOL PTO REIMBURSEMENT
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* RECEIPTS MUST BE ATTACHED* (IF NECESSARY TAPED TO A SHEET OF ADDITIONAL PAPER)
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REQUESTOR'S NAME:DATE:
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PAYABLE TO:REQUESTOR'S EMAIL ADDRESS:
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ADDRESS:REQUESTOR'S PHONE NUMBER:
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COMMITTEE NAME:
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PHONE NUMBER:COMMITTEE CHAIR:
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COMMITTEE CHAIR FBMS PTA EMAIL ADDRESS:
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COMMITTEE CHAIR/VP APPROVAL:
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2nd COMMITTEE CHAIR/VP APPROVAL (for debit card):
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DATEITEM DESCRIPTION
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INVOICE NUMBERPLACE OF PURCHASEBUDGET CATEGORYAMOUNT
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Comments/Remarks:
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 Amount Due:$0.00
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(sales tax is NOT reimbursable)
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TREASURER'S NOTES:
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Receipts Included: Y / N
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Date Finance Approved:
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Check #:Please return in person to treasurer's inbox at school or via email to:
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Initials:treasurer@fbmspto.org
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