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Reimbursement Form
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SDPTA REQUEST FOR REIMBURSEMENT

Mileage Reimbursement: 

Date of Transaction: _____              Committee Billed: ______________________

Date Submitted:  _______                 Committee Chair: ______________________

 

SDPTA Member to be reimbursed (please print)

    Signature _________________________________________

    Address __________________________________________

    Phone Number ____________________________________

 

Description:

 

Total Amount:  __________________

 

Committee Chair  Signature  ________________________________________________

 

Treasurer Signature ______________________________________________________

Please attach original receipts for reimbursement.  This form must be submitted to the committee chairs for signature, and then sent to the treasurer for reimbursement.  In keeping with the bylaws of the SDPTA, any expense that exceeds the budgeted amount by $100 or any amount over $1000 must be approved by the SDPTA executive board before it can be reimbursed.