25-26 Reimbursement Request Form

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Attach up to 3 files/pictures/scans of all receipts and supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
The treasurers will e-mail you when your check is ready to be picked or has been mailed to you.
Questions? Please e-mail our treasurer at treasurer@sequoyaapt.com.

Name Company Name (if applicable) Email: How would you like to receive your reimbursement*

FOR ZELLE REIMBURSEMENTS:
Phone Number and/or Email We need the phone number and/or email linked to your Zelle account. Please provide what name your Zelle is listed under so we can ensure we have the correct account.

FOR MAIL/PICK UP REIMBURSEMENTS:
Check made payable to: Mailing Address:

REIMBURSEMENT DETAILS:
Committee/Event Total Amount Requested for Reimbursement/Payment: Description/Purpose: Attach Receipt/Invoice #1 Attach Receipt/Invoice #2 Attach Receipt/Invoice #3 Date Check Needed (please allow at least 1-2 weeks if possible + additional time if mailing option is chosen):