EmailMe Form - USWT Expense Voucher

USWT Expense Voucher

This form is to be used for reimbursement of expenses on behalf of the USWT.

Use the File Upload feature to attach all receipts, and itemize expenses below. Signatures can be done by your mouse, or your finger on a writable screen.

Responses to the online form will be viewed by the USWT Treasurer, and your state contact. Fill in as much information as you know. Upon completion of the form, click Submit; you will receive a confirmation screen if your form has been successfully submitted. (rev 2017)

Your Email *
State *
Other State
If you are a member of a state organization not listed, please enter your state.
Position
Choose the appropriate position that you hold
Other Position Explanation *
Submitter Name *
First Last
Phone
### - ### - ####
Address

Street Address City State / Province / Region Postal / Zip Code
Expense Type *
Phone
Postage
Copies & Supplies
Incentives
Travel
Miscellaneous/Other
Vendor Reimbursement
Phone Expense Description *
Please include a brief description of your expenses
Phone Expense Quantity
Phone Expense Amount *
$ Dollars . Cents
Postage Expense Description *
Please include a brief description of your expenses
Postage Expense Quantity
Postage Expense Amount *
$ Dollars . Cents
Copies & Supplies Expense Description *
Please include a brief description of your expenses
Copies & Supplies Quantity
Copies & Supplies Amount *
$ Dollars . Cents
Incentives Expense Description *
Please include a brief description of your expenses
Incentives Quantity
Incentives Amount *
$ Dollars . Cents
Travel Expense Description *
Please include a brief description of your expenses
Travel Quantity
Travel Amount *
$ Dollars . Cents
Miscellaneous/Other Expense Description *
Please include a brief description of your expenses
Miscellaneous/Other Quantity
Miscellaneous/Other Amount *
$ Dollars . Cents
Vendor Name *
Vendor Reimbursement Expense Description *
Please include a brief description of your expenses
Vendor Reimbursement Amount *
$ Dollars . Cents
File Upload

Add File

Upload copies of materials or media coverage
Signature *
Clear
FOR TREASURER'S USE ONLY
THE FOLLOWING ITEMS ARE ONLY FOR THE USWT TREASURER!
Be sure to complete the reCAPTCHA above the submit button in order to submit this form.
Annual Budget
$ Dollars . Cents
Date Paid
MM / DD / YYYY
Paid Year-to-Date
$ Dollars . Cents
Paid This Voucher
$ Dollars . Cents
Check Number
Total Paid
$ Dollars . Cents
Remaining Budget
$ Dollars . Cents
Approved by Signature
Clear

FOR TREASURER'S USE ONLY