Miscellaneous Expense Reimbursement Form (New Hamburg Hockey Association)

Miscellaneous Expense Reimbursement Form

To be reimbursed, coaches/executive members must provide the associations Treasurer with proof of the expense and documentation from the executive who has approved this expense.

Contact Information

Information about the person requesting reimbursement

First and Last Name^*

Required

Address^*

Required

Number / Street Name

City^*

Required

Postal Code^*

Required

A1B2C3

Contact Number^*

Required

Example: ###-###-####

E-mail for Reimbursement

CAREFULLY enter the email address where you would like us to send payment. Please understand that if you enter the wrong email address on this form, your payment may be permanently lost.

Email Address for payment via e-transfer^*

Required

Example: [email protected]

Expense Approval

Information about expense approval

Expense Approved by:^*

Required

First and Last Name of NHHA Executive member

Expense Details

Enter Information about the expense. NOTE: You may submit only ONE expense per form. If you have multiple expenses, you must submit them individually.

Describe the expense in detail:^*

Required

e.g. Describe the product/service purchased and what it was for

Amount^*

Required

Total amount of expense being submitted for reimbursement

Date of Expense^*

Required

Date when purchase was made/paid.

Attachments

Receipt and Pre- Authorized Banking Attachments

Please attach scanned copy of receipt^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 2. Maximum File Size: 4MB.

Please attach a scanned copy of any other important information:

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.

Miscellaneous Expense Reimbursement Form (New Hamburg Hockey Association)

OMHA Digital Network

Contact Information

E-mail for Reimbursement

Expense Approval

Expense Details

Attachments

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