Pta Reimbursement Form printable pdf download

KIDS ARE THE HEART OF AUGUSTA CIRCLE ● KIDS ARE THE HEART OF AUGUSTA

CIRCLE ● KIDS ARE THE HEART OF AUGUSTA CIRCLE ● KIDS ARE THE HEART

PTA REIMBURSEMENT FORM

OF AUGUSTA CIRCLE ● KIDS ARE THE HEART OF AUGUSTA CIRCLE ● KIDS ARE

THE HEART OF AUGUSTA CIRCLE ● KIDS ARE THE HEART OF AUGUSTA CIRCLE

PLEASE STAPLE RECEIPTS TO THE BACK OF THIS FORM

Payable to: _______________________________________________________ Date: ____________________________

Address: _________________________________________________________ Phone: __________________________

Child’s Name: _____________________________________________________ Teacher: _________________________

Voucher submitted by (if different than payee) ____________________________________________________________

Mail check to address above

Leave check in my PTA folder

Send check home with my child

PTA PURCHASES

Please list each retailer (Staples, Publix, Costco, etc.), a general description of the items purchased (poster board,

cookies, etc.), and the total amount being submitted for payment. List each receipt separately. If this is an invoice that

your Treasurer should pay directly to the merchant, please note that in the Remarks section below.

Place of Purchase

Items – Brief Description

Event/Budget Line Item

Amount

TOTAL REIMBURSEMENT REQUEST

Notes/Remarks: ____________________________________________________________________________________

__________________________________________________________________________________________________



Use Tax‐Exempt Form when making purchases intended for resale.



Attach all copies of receipts, purchase orders, invoices, or bills to the back of this form. Receipts are required

for PTA Financial Review and tax‐reporting purposes.



Return completed forms to the PTA Treasurer’s Box in the Teacher Mailbox area.



Please allow two weeks for the voucher to be received, approved, and processed for payment.

Treasurer’s Notes:

Date rec’d: ____/____/____

Date paid: ____/____/____

Chk number: __________ Chk amount: $_________

Initials ________________

Pta Reimbursement Form