Credit Card Payment Request Form

Instructions:

Fill out completely with description of items to be purchased and breakdown of expenses by budget category (missing info will delay payment).
Attach a PDF of the receipt.
REMEMBER – PTA DOES NOT PAY SALES TAX on items purchased for its use; therefore the credit card cannot be used on purchases with tax included.
Contact treasurer@waispta.org with any questions.

Credit Card Payment Request Information

Only one credit charge per form. Items purchased can be grouped by budget category below.

Requestor:

Place of Purchase

Is this purchase tax free? (reset)

Yes No

We cannot reimburse tax as a PTA. If this purchase includes tax, we cannot use the PTA credit card.

Total Amount For Credit Charge:

Please separate expenses by budget category.

Expense 1 - Amount

Budget Category

Short description of item(s) purchased:

Expense 2 - Amount

Budget Category

Short description of item(s) purchased:

Expense 3 - Amount

Budget Category

Short description of item(s) purchased:

Expense 4 - Amount

Budget Category

Short description of item(s) purchased:

Attach Receipts