Funds Request Form

Instructions:

Fill out completely with description of reimbursement and breakdown of expenses by budget category (missing info will delay payment).
Attach receipts - preferably in PDF format. Receipts can be copied and combined into a single file. If you are requesting a check for a vendor - please attach the contract as one of the receipts.
Specify how you would like to be paid.
REMEMBER – PTA DOES NOT PAY SALES TAX on items purchased for its use; therefore sales tax will not be reimbursed
A receipt of your submitted request will be emailed to you (keep for your records).
Please contact treasurer@waispta.org with any questions or concerns.

Reimbursement Information

Requestor:

Total Amount For Reimbursement:

How would you like to receive your money? (reset)

Check Zelle ACH Payment (Treasurer Use only)

We would prefer to reimburse with Zelle. If a check is requested and lost, please be aware that there is a $25.00 fee to reissue a check.

If you requested a check, provide your address for delivery.

If you requested zelle, please provide your phone number or email linked to your account.

Please separate expenses by budget category, even if they are on the same receipt.

Amount

Budget Category

Please provide a brief description of purchase:

Place of Purchase

Amount

Budget Category

Please provide a brief description of purchase:

Place of Purchase

Amount

Budget Category

Please provide a brief description of purchase:

Place of Purchase

Amount

Budget Category

Please provide a brief description of purchase:

Place of Purchase