Expense Reimbursement Request (Church Voucher)

Use this if you've used your own money to purchase something for church and you'd like to be reimbursed.

Expense Reimbursement Payment Voucher

Good Shepherd Lutheran Church

ExpenseVoucher: to download a blank form,
or fill in everything below and click Submit.

Use this form when you've used your own money to purchase something for church and you'd like to be reimbursed. After submitting this form, send receipts to Carol Gottschalk. You may drop them in Carol's mailbox at church, or by mail them to her home: 1101 Kingham Drive, Midlothian, VA 23114.
_________________________________________________

Requested By: (Required)

Your name.

Your E-Mail Address

(not required)

Date of Request: (Required)

Today's Date

/ /

Date Needed By:

When you'd like to receive the money. Default is 2 weeks from the day all documentation is received.

/ /

Payee: (Required)

The check will be written to this person.

Send Check To: (Required)

The check will be delivered to this person. Default is the Payee.

Description of Expense(s): (Required)

What was the money spent on? If you know the name of the Budget Line Item, please enter it also. If you don't, that's fine.

$ Amount of Check: (Required)

Don't enter $ sign, just enter the amount.

Delivery: (Required)

Where to send the check. Options include GS Church Office, or any US Postal Address (include full street address, city, state, zip).

For Office Use Only

Approved By:_____________________________________________

Date Paid:_______________________________________________

Check No.:_______________________________________________

Check Signed By: _________________________________________

Personal tools

Expense Reimbursement Request (Church Voucher)

Expense Reimbursement Payment Voucher

For Office Use Only

Please join us on Sunday mornings at 10:30 a.m. for our worship service.

We are located at: 1401 Old Hundred Rd. Midlothian, VA 23114