Miscellaneous Expense Reimbursement Form (New Hamburg Hockey Association)
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Miscellaneous Expense Reimbursement Form
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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
*
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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.
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