EXPENDITURE REQUEST FORM

SELECT YOUR PURCHASING METHOD:

Credit Card

Check

Reimbursement (pre-approval required)

Other

Request Date

MM

DD

YYYY

Requestor's Name

First Name

Last Name

Team Department:

Requestor's Email:

Amount Requested:

Purpose of Expense:

Is this "request" included in your 2021 budget?

Yes

No

PLEASE NOTE:

Please allow 48-72 hours for approval and disbursement of funds/card access. Receipts must be turned in immediately after purchases are made. Failure to submit receipts will result in the requestor being personally responsible for any purchases that have not been accounted for at the time.