Bittersweet Garden Club

Payment/Reimbursement Authorization

Please complete to request payment for club related expenses.

All expenses should be approved in advance by the Treasurer and President.

INSTRUCTIONS

Enter your information in the fields below.

Save document for your records, if you choose.

Print out form, sign, and submit to treasurer along with receipt or invoice.

Payee Name: Click or tap here to enter name.

Payee Street Address: Click or tap here to enter street address.

Payee City/State/Zip: Click or tap here to enter City/State/Zip.

Purpose of Expenditure: Click or tap here to enter purpose of expenditure.

Payment/Reimbursement Amount Requested: Click or tap here to enter amount requested.

Signature of Requester:

APPROVAL

President Approval Signature:

Treasurer Approval Signature:

Check #:	Amount:	Date Issued: