Expense Voucher - The North Parish Church of North Andover

If your team/committee has a budget line for the expenses, complete and submit this form, including a PDF or JPG copy of your receipt(s). A check will be mailed to you or to the designated supplier/vendor.

If you are covering the expense as a donation, use this same form to request a donation receipt. An acknowledgement of your donation (suitable for tax purposes) will be mailed to you.

Date of submittal
MM slash DD slash YYYY
Request submitted by
First Last
Request is for
- Reimbursement or payment of expense
- Acknowledgement of donation for expense
If reimbursement or payment of expense, make check payable to (individual name or company)
Mail check or donation acknowledgement to(Required)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Expense(s) for items:(Required)
Please attach PDF or JPEG image of receipts; if more than 3 attachments are needed, please submit on a separate form
Total Amount
Enter the total amount to be reimbursed or acknowledged.
Attach image file
Max. file size: 128 MB.
Attach image file
Max. file size: 128 MB.
Attach image file
Max. file size: 128 MB.
Charge this expense to (committee, team, expense category, fund etc)(Required)
(for office use) Expense was authorized by
- Minister
- Committee/team chair
- Treasurer