Finance Use this form to request reimbursement for expenses, or to report use of the Church Debit Card. Unique IDRequest Type*Reimbursement RequestDebit Card PurchaseDate of Transaction* Date Format: MM slash DD slash YYYY Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Vendor Name*Purchase Description:*Please list all items on this purchase.Item DescriptionQuantityRateAmount Amount TotalBudget Category*Select below with the most accurate budget category for this expense: OfficeFinanceSPPRCTrusteesOutreachMinistriesWorshipPastor Professional ExpensesOffice Sub CategoryOffice SuppliesPostageAdvertisingEquip Lease Or ServicingPaperFinance Sub CategoryBank FeesCheck FeesLate FeesSPPRC Sub CategoryPayrollGuest Speaker FeesTaxesTrustees Sub CategoryState/Local Fees or TaxesInsuranceLabor for Repairs or MaintenanceUtilities Trash Water InternetSnow Removal/Lawn & SprinklerSuppliesOutreach Sub CategoryEFAAHabitat For HumanityBUMMPMinistries Sub CategoryEducationUMMUMWUMYFWorship Sub CategoryMusicRobesBellsAV EquipmentCandlesSuppliesPastor Sub CategoryEvent Registration FeesDues (i.e. Office 360)Travel & MealsEmergency Relief FundBooks & SoftwareSupplies & EquipmentPlease attach receipts for this purchase*Receipts for all line items are required for reimbursement. Drop files here or NameThis field is for validation purposes and should be left unchanged.