TEAM Reimbursement Form
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Paly TEAM
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Expense Reimbursement
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Please complete ALL of the following:
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Date:
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Your Name:
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Your Phone #:
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Your Email Address:
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Make Check Payable to:
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Mail Check to:
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Please attach your receipt(s) / invoice(s) to a separate sheet.
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Please submit your expense request within 45 days of expense date.
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Line #DateExpense AmountExpense DescriptionEvent / Reason
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Total Expenses:
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Mail reimbursement request to:
TEAM Treasurer
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Sally Kadifa
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610 Coleridge Ave
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Palo Alto, CA 94301
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Questions? Email PalyTeamTreasurer@gmail.com
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