Reimbursement Request - Arizona Federation of Garden Clubs

Expense Reimbursement Form

Any reimbursement request that exceeds the budgeted amount will be submitted by the Treasurer to the Executive Committee for approval before payment.

Expenses incurred before May 1 must be submitted by May 31. Any expenses incurred in May must be submitted by June 15.

"*" indicates required fields

Position*

Name*

Date*

Address*

(if different from address in Directory)

Mileage

Date

Destination

Miles

Amount (14 cents/mile)

Total Amount For Mileage

Other Expenditures

Date

Description

Amount

Total Amount For Other Expenditures

Total Amount Requested

Attach Scanned Receipts

Drop files here or

Max. file size: 128 MB.

Signature

Email*

Select Your Preferred Method to file for Reimbursement, then Click on Submit

Mail-in – Please email me a copy of my completed form and the Mail-in address; I will send a copy of my form to the Mail-in address along with copies of my scanned receipts.

Electronically – Please accept my completed form when I click on Submit; I have attached my scanned receipts.