Expense Form

Person requesting funds:

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Type of Expenses

Travel Expenses

Non-Travel Expenses

Travel Expenses

*This expense is in support of which committee or program and/or from which line item in the budget?:

I would prefer for my travel to be used as a tax deduction on my personal return:

Yes

Volunteers. If you perform services as a volunteer worker for a qualified charity, you may be able to deduct some of your costs as a charitable contribution. Complete this form and retain for your records

If you drive for a non-profit organization, including qualified churches and religious organizations, you can claim mileage you drive for volunteering as a donation to that organization, including the mileage you drive to and from the organization in order to volunteer. You can take a standard deduction of 14 cents per mile on your tax return. Or, if it's more advantageous and you kept track, you can deduct the actual cost of your gas for your philanthropic driving. With either choice, you also can include any parking fees or tolls paid. You must keep track of your mileage, the purpose of the trip, AND the name of the organization which you were representing on every trip recorded.

Personal Vehicle Use:

total number miles traveled

Multiple by $0.14 center per mile

I would prefer to be reimbursed by the Presbytery:

Yes

Details of Request for travel expense reimbursement:

Expense: Amount:

Personal Vehicle Use:

total number miles traveled

Multiply by $0.30 per mile ($0.725 if you are a staff member)

Meals (receipt required):

Lodging (receipt required):

Airfare (receipt required):

Rental Vehicle (receipt required):

Other expenses (receipt required)

Subtotal

Deduct any funds advanced for travel:

Total expenses claimed for reimbursement

Upload any receipts needed.

Drop files here or

Max. file size: 64 MB.

Signature of Requestor(Required)

Date(Required)

Non Travel Expenses

Request for office supplies and expendable materials, services or equipment:

Item

Charge to budget line item

*Notes:

Amount:

Total Estimated Costs

Please do not purchase items or services before authorization has been obtained.

Please give a brief explanation of how and where this service or equipment will be used on the back of this sheet if there is not enough room above

Upload any receipts needed.

Drop files here or

Max. file size: 64 MB.

Name/Title of Requestor(Required)

Date(Required)