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l]SOUTH TEXAS
YOUTH SOCCER
Affiliated with United States Youth Soccer		2851 Joe DiMaggio Blvd. #23
Round Rock, TX 78665
P: (512) 272-4553
F: (512) 272-5167
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Name: Mira MupierPhone #:(979) 331-4010
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Email:Mkmupier@gmail.com
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Mailing Address:14722 Cedar Isle Drive
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City:HoustonState:TXZip:77084
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The purpose of the following expenses: Event / Activity
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Location:
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ODP POOL Training 3&4
San Marcos Girls 2014 Morning (2x)Girls 2014 Afternoon (2x)
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Date(s):11/22 & 11/23Girls Morning & Girls Afternoon
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Admin Only
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Date(s)DescriptionAmountAccount Code
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Stipends Days x Rate..2$250.00
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Mileage - (amount pulls from calculator at the bottom)$31.00
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Meals (Please attach detailed receipts)
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Supplies
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Total$281.00
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*The above expenses will not be paid unless receipts are included
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Mira Mupier
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Signature of person requesting reimbursement Date
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Signature & title of person approving reimbursement Date
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President, South Texas Youth SoccerDate
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As President of South Texas Youth Soccer, I authorize the above request.
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Treasurer, South Texas Youth SoccerCheck #Date
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Mail completed form and receipts to:
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South Texas Youth Soccer Association
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2851 Joe DiMaggio Blvd. #23
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Round Rock, TX 78665
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MILEAGE VS. RENTAL CALCULATOR
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MUST BE COMPLETED BY ENTERING MILEAGE AND DAYS. LOWEST AMOUNT SHOWS UP ON THE FIRST PAGE
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Round trip mileagereim/miletotal mileage costrent/day# of daystotal rentalEst Gas CostEst rental fee
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1240.7$86.80$54.00$0.00$31.00$31.00
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