Miscellaneous Expense Reimbursement Form (New Hamburg Hockey Association)

Print 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^*
Address^*

Number / Street Name
City^*
Postal Code^*

A1B2C3
Contact Number^*

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^*

Example: [email protected]

Expense Approval

Information about expense approval

Expense Approved by:^*

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:^*

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

Total amount of expense being submitted for reimbursement

Date of Expense^*

Open the calendar popup.

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.

Human Validation

Check The Box ^*

Miscellaneous Expense Reimbursement Form (New Hamburg Hockey Association)

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