REIMBURSEMENT REQUEST

First Name

Last Name

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Postal Code

REIMBURSEMENT DETAILS

PLEASE COMPLETE ONE REIMBURSEMENT PER TRIP

Dates of Trip/Expense

Total amount to be reimbursed

Associated Cost Center

Please select... 3rd Party - 0800 Redneck - 0853 BBB - 0850 Boots & Barrels - 0852 Raley Road Trip - 0854 PBR - 0855 Fundraising - 1100 Retail - 1116 Grant Management - 1120 G&A (General/Administrative) - 1200 Health and Wellness - 1500 Awareness 1501 Santa Boots 1502 Mistake Credit Card Charges - 1630

You may upload receipts individually OR as one file. If uploading multiple receipts in one file please use the "Details" box below to provide associated Expense Codes and descriptions for each receipt included in the file.

Upload Receipt

File Name: Date_Amount_Vendor

Associated Expense Code

Please select... 4996 Temporarily Restricted Revenue 5100 ER FICA 5110 State Unemployment 5120 Group Health & Disability 5200 Rent Expense - the Slate, Storage Room in Tyler 5218 State Taxes 5220 State Registrations 5240 General Liability insurance/Directors and Officers 5242 Workers Compensation 5320 Vehicle Expense 5400 Office Supplies/Expense (Reg. Office Supply Needs but also packaging, wrapping etc. when used for Santa Boots) 5410 - Printing 5425 Appreciation & Hospitality 5427 Special Fundraising Event Expense 5430 Program Supplies/Expense 5480 Books & Subscriptions (software subscriptions - but refer to 2021 subscription google document) 5590 Telephone (verizon ipads) 5600 Postage - For Stamps/General Check Mailing 5620 Shipping - ALL shipping 5660 Marketing 5670 Advertising 5700 Audit Fees 5710 Legal Fees 5720 - Computer/IT Services (hardware and repair not software) 5735 Payroll Service Fees 5740 Bank and CC Processing Fees 5750 Indiv Contract Fees for Prof Services 5800 Staff Travel 5805 Other Official Travel - board travel, veteran ambassador travel, H/W travel expense 5810 Meetings & Conferences - staff conf fees & other mtgs with attendance fees, BOD meeting supplies/food 5825 Staff Development - staff retreats, staff dinners, etc 5830 Cost of Goods Sold - Retail products, fees, some shipping from vendors etc.

Upload Receipt

Associated Expense Code

Please select... 4996 Temporarily Restricted Revenue 5100 ER FICA 5110 State Unemployment 5120 Group Health & Disability 5200 Rent Expense - the Slate, Storage Room in Tyler 5218 State Taxes 5220 State Registrations 5240 General Liability insurance/Directors and Officers 5242 Workers Compensation 5320 Vehicle Expense 5400 Office Supplies/Expense (Reg. Office Supply Needs but also packaging, wrapping etc. when used for Santa Boots) 5410 - Printing 5425 Appreciation & Hospitality 5427 Special Fundraising Event Expense 5430 Program Supplies/Expense 5480 Books & Subscriptions (software subscriptions - but refer to 2021 subscription google document) 5590 Telephone (verizon ipads) 5600 Postage - For Stamps/General Check Mailing 5620 Shipping - ALL shipping 5660 Marketing 5670 Advertising 5700 Audit Fees 5710 Legal Fees 5720 - Computer/IT Services (hardware and repair not software) 5735 Payroll Service Fees 5740 Bank and CC Processing Fees 5750 Indiv Contract Fees for Prof Services 5800 Staff Travel 5805 Other Official Travel - board travel, veteran ambassador travel, H/W travel expense 5810 Meetings & Conferences - staff conf fees & other mtgs with attendance fees, BOD meeting supplies/food 5825 Staff Development - staff retreats, staff dinners, etc 5830 Cost of Goods Sold - Retail products, fees, some shipping from vendors etc.

Upload Receipt

Associated Expense Code

Please select... 4996 Temporarily Restricted Revenue 5100 ER FICA 5110 State Unemployment 5120 Group Health & Disability 5200 Rent Expense - the Slate, Storage Room in Tyler 5218 State Taxes 5220 State Registrations 5240 General Liability insurance/Directors and Officers 5242 Workers Compensation 5320 Vehicle Expense 5400 Office Supplies/Expense (Reg. Office Supply Needs but also packaging, wrapping etc. when used for Santa Boots) 5410 - Printing 5425 Appreciation & Hospitality 5427 Special Fundraising Event Expense 5430 Program Supplies/Expense 5480 Books & Subscriptions (software subscriptions - but refer to 2021 subscription google document) 5590 Telephone (verizon ipads) 5600 Postage - For Stamps/General Check Mailing 5620 Shipping - ALL shipping 5660 Marketing 5670 Advertising 5700 Audit Fees 5710 Legal Fees 5720 - Computer/IT Services (hardware and repair not software) 5735 Payroll Service Fees 5740 Bank and CC Processing Fees 5750 Indiv Contract Fees for Prof Services 5800 Staff Travel 5805 Other Official Travel - board travel, veteran ambassador travel, H/W travel expense 5810 Meetings & Conferences - staff conf fees & other mtgs with attendance fees, BOD meeting supplies/food 5825 Staff Development - staff retreats, staff dinners, etc 5830 Cost of Goods Sold - Retail products, fees, some shipping from vendors etc.

Upload Receipt

Associated Expense Code

Please select... 4996 Temporarily Restricted Revenue 5100 ER FICA 5110 State Unemployment 5120 Group Health & Disability 5200 Rent Expense - the Slate, Storage Room in Tyler 5218 State Taxes 5220 State Registrations 5240 General Liability insurance/Directors and Officers 5242 Workers Compensation 5320 Vehicle Expense 5400 Office Supplies/Expense (Reg. Office Supply Needs but also packaging, wrapping etc. when used for Santa Boots) 5410 - Printing 5425 Appreciation & Hospitality 5427 Special Fundraising Event Expense 5430 Program Supplies/Expense 5480 Books & Subscriptions (software subscriptions - but refer to 2021 subscription google document) 5590 Telephone (verizon ipads) 5600 Postage - For Stamps/General Check Mailing 5620 Shipping - ALL shipping 5660 Marketing 5670 Advertising 5700 Audit Fees 5710 Legal Fees 5720 - Computer/IT Services (hardware and repair not software) 5735 Payroll Service Fees 5740 Bank and CC Processing Fees 5750 Indiv Contract Fees for Prof Services 5800 Staff Travel 5805 Other Official Travel - board travel, veteran ambassador travel, H/W travel expense 5810 Meetings & Conferences - staff conf fees & other mtgs with attendance fees, BOD meeting supplies/food 5825 Staff Development - staff retreats, staff dinners, etc 5830 Cost of Goods Sold - Retail products, fees, some shipping from vendors etc.

Upload Receipt

Associated Expense Code

Please select... 4996 Temporarily Restricted Revenue 5100 ER FICA 5110 State Unemployment 5120 Group Health & Disability 5200 Rent Expense - the Slate, Storage Room in Tyler 5218 State Taxes 5220 State Registrations 5240 General Liability insurance/Directors and Officers 5242 Workers Compensation 5320 Vehicle Expense 5400 Office Supplies/Expense (Reg. Office Supply Needs but also packaging, wrapping etc. when used for Santa Boots) 5410 - Printing 5425 Appreciation & Hospitality 5427 Special Fundraising Event Expense 5430 Program Supplies/Expense 5480 Books & Subscriptions (software subscriptions - but refer to 2021 subscription google document) 5590 Telephone (verizon ipads) 5600 Postage - For Stamps/General Check Mailing 5620 Shipping - ALL shipping 5660 Marketing 5670 Advertising 5700 Audit Fees 5710 Legal Fees 5720 - Computer/IT Services (hardware and repair not software) 5735 Payroll Service Fees 5740 Bank and CC Processing Fees 5750 Indiv Contract Fees for Prof Services 5800 Staff Travel 5805 Other Official Travel - board travel, veteran ambassador travel, H/W travel expense 5810 Meetings & Conferences - staff conf fees & other mtgs with attendance fees, BOD meeting supplies/food 5825 Staff Development - staff retreats, staff dinners, etc 5830 Cost of Goods Sold - Retail products, fees, some shipping from vendors etc.

Details about reimbursement:

Additional notes regarding this reimbursement:

Miles Driven

Total mileage to be reimbursed

Mileage calculated based off 2024 rate of 67 cents per mile

Trip Details

Boot Campaign POC/Direct Report email (for reimbursement authorization and approval)

Form Updated January 2024