EmailMe Form - AP-LS Payment/Reimbursement Form

AP-LS Payment/Reimbursement Form

Please submit a separate Payment Request for each trip, vendor payment, etc.

Submit this form and upload all applicable receipts or invoices.

After you submit this form, you will receive an email confirmation and it will be emailed to the APA finance department for processing.

Remember to review the budget rules document.

Links to blank forms and referenced information

Download ACH Form Here

Download W9 Form Here

Download W8 Form Here

AP-LS Budget Code Sheet

Reimbursement Policies

Any travel receipts for reimbursement should be submitted within 2 weeks of travel to comply with APA Accounting’s deadlines.

Payee Information

The payment name needs to match the ACH and W-9. If payment is to a business all the paperwork and request needs to have the business name and address.

Payment is being made to a

Business or Institution

Payee Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

### - ### - ####

Name of person filling out this form (only if different then payee)

Email of who is filling out this form (only if different then payee)

I am requesting the payment as a *

If other, please specify.

Committee/category of the person submitting the request

Please select which one this reimbursement request best represents.

Let us know if there any additional information or instructions regarding this submission.

File Upload

Add File

If you have any additional files to upload
Forms Required to Be Reimbursed
The following three forms are required to be submitted or must already be on file in order to be reimbursed.
If your bank account information including name or address has changed since you were last reimbursed, you will need to fill out a new ACH & W9/W8 Form.

Note: If you do not know if your ACH and W9/W8 are on file and accurate, please fill out the forms and attach. If you submit that they are on file and they are not, your reimbursement will take longer to process.
ACH Form *
I am attaching the form for processing.
The recipient's current ACH form is already on file with APA and does not need to be attached.
The recipient's ACH form was submitted via the Google Drive for processing.
ACH Upload *
W9/W8 Form *
I am attaching the form for processing.
The recipient's current W9 form is already on file with APA and does not need to be attached.
The recipient's ACH form was submitted via the Google Drive for processing.
W9/W8 Upload *
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