Expense / In-kind Donation Form

*This is for:
Reimbursement In-kind Donation

Date Required:

*Committee:

*Description:

*Amount:

*Chair/VP Approval:
Yes
No

*Please Attach Scan of Receipt:

Please ensure the attachment is legible and in PDF file format. Thank you!

*Payee/Donor Name:

*Mailing Address:

*Email Address:

Special Handling:

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