Check Request/Reimbursement Request Form

Instructions:

Please fill out completely with description of reimbursement and breakdown of expenses.
Attach up to 3 files/pictures/scans of all receipts and supporting documentation.
A receipt of your submitted request will be e-mailed to you (please keep for your records).
The treasurers will e-mail you when your check is ready to be picked or has been mailed to you.
Questions? Please e-mail our treasurer at terraceelempta.treasurer@gmail.com

As always, please remember: As a sales tax exempt organization, we cannot reimburse sales tax, so please give all vendors a copy of our sales tax exemption form to avoid being charged sales tax when you make your purchase.

Request Date

Please complete the following information for the requestor/payee.

Total Amount Requested for Reimbursement/Payment:

Please complete the following information for the requestor/payee. Sales Tax should not be included in total amount.

Name of Requestor

Please complete the following information for the requestor/payee.

Please complete the following for the requestor/payee

Phone Number

Please complete the following information for the requestor/payee

Are You a Current TCE PTA Member?

Yes No

Check made payable to:

Please enter name of person/business to whom the check should be paid (the payee).

Date Check Needed (please allow at least 1-2 weeks if possible):

Should the check be mailed directly to the vendor/payee or dropped off at school?

Please mail to vendor/payee Please leave with front desk staff @ Terrace

Mailing Address

If mailing the check, what is the mailing address of business or payee?

Description/Purpose:

Briefly explain the description and purpose of this purchase.

Attach Receipt/Invoice #1

Attach Receipt/Invoice #2

Attach Receipt/Invoice #3

I, the requester, understand that I am requesting funds from Terrace Elementary PTA and such funds are restricted under the guidelines set forth by Texas and National PTA. I will provide any documentation requested by TCE PTA to authorize a payment or review the appropriateness of this request.