Expense Form

Please fill out all fields and submit along with receipts, and we will get you reimbursed by e-transfer (cash for under $50).

First name

Last name

Email for e-transfer (please ensure you have direct deposit)

___________

Date of receipt

Invoice/Transaction #

Store name

Total of receipt

Description of purchase

Allocated for:

___________

Date of receipt

Invoice/Transaction #

Store name

Total of receipt

Description of purchase

Allocated for:

___________

Date of receipt

Invoice/Transaction #

Store name

Total of receipt

Description of purchase

Allocated for:

___________

Date of receipt

Invoice/Transaction #

Store name

Total of receipt

Description of purchase

Allocated for:

___________

Date of receipt

Invoice/Transaction #

Store name

Total of receipt

Description of purchase

Allocated for:

____________

TOTAL OF EXPENSE CLAIM:

We acknowledge the unceded territory and ancestors of Coast Salish First Nations of Salt Spring Island & surrounding areas who continue to use and steward the lands and waters of the Salish Sea.