HHL Expense Reimbursement Voucher

Requested by:

Requestor's email:

Date

Committee Chair Email

Brief description of expenses

Amount Requested

Make Check Payable to:

Upload Receipt File

Upload

Yes

I agree the above statements are true and correct documentation of receipts and/or other items of proof are hereby attached to verify all amounts listed.

Your Signature

Financial Secretary Name

Budget Line Item

Account

Operational Expense

Program of Service

Alpha Academy

Treasurer

Date

Check Amount