PTA Reimbursement & Check Request Form 2024-2025

INSTRUCTIONS:

1. Fill out completely with description of reimbursement and breakdown of expenses by budget category.

Please refer to the approved budget to properly categorize your items. Requests that do not include an active or available budget category will be delayed in processing.

2. Receipts are required to be attached to your reimbursement request! Please do not include iPhone pictures, we are not able to open .heic files. If you have trouble uploading your receipts, please email the receipts to the treasurer at treasurer@nhepta.org.

3. Specify if the check should be dropped in your mailbox, mailed to a vendor, dropped off at school, or should be made out to someone other than the requestor.

4. REMEMBER – PTA DOES NOT PAY SALES TAX on items purchased for its use; we cannot reimburse for those costs. If you need an exemption form please reach out to the Treasurer.

5. A receipt of your submitted request will be emailed to you (please keep it for your records).

REIMBURSEMENT INFORMATION

Check Payable to:

Total Amount for Reimbursement

Where should the check be sent/given?

If check is to be mailed, please provide the address.

EXPENSES FOR REIMBURSEMENT

EXPENSE 1:

Expense Amount #1

Expense is for:

Place of Purchase:

Board Position or NHE Faculty

Expense 1 Budget Line or Expense Type:

Faculty Reimbursement Expenses

Budget Expenses

Designated Funds

Other:

Attach Receipts for Expense 1:

To attach an image or file of your receipt, please click the gray "choose file" button. You must submit the form (or complete the checkout process) in order for the file to be received. You will also be able to confirm the file was attached by looking at the "Details" section of your order confirmation receipt.

Expense 1 Receipt 1

Expense 1 Receipt 2

Expense 1 Receipt 3

EXPENSE 2:

Expense Amount #2

Expense is for:

Place of Purchase:

Board Position or NHE Faculty

Expense 2: Budget Line or Expense Type:

Faculty Reimbursement Expenses

Budget Expenses

Designated Funds

Other:

Attach Receipts for Expense 2:

Attach Expense 2 Receipt 1

Attach Expense 2 Receipt 2

Attach Expense 2 Receipt 3

EXPENSE 3:

Expense Amount #3

Expense is for:

Place of Purchase:

Board Position or NHE Faculty

Expense 3: Budget Line or Expense Type:

Faculty Reimbursement Expenses

Budget Expenses

Designated Funds

Other:

Attach Receipts for Expense 3:

Attach Expense 3 Receipt 1

Attach Expense 3 Receipt 2

Attach Expense 3 Receipt 3

Attach Additional Receipts or Files

APPROVAL

(to be completed by the Treasurer)

Approved By:

Approval Date:

Approved By:

Approval Date:

TREASURER'S NOTES

Date Check Issued:

Check Number:

Notes:

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