Check Request – Austin Christian Church

Check Request Form

Please complete the form below to be reimbursed for an expense made on behalf of Austin Christian Church. Checks will be mailed to the address indicated on this form and under normal circumstances you will receive your reimbursement within two weeks from the date submitted.

Community Church*
Make Check Payable to*
All reimbursements to staff members will be delivered via electronic deposit.
Are you currently set up to receive reimbursement checks from Austin Christian via electronic deposit?*
- Yes
- No
- I don't know
Address Where the Check Will Be Mailed*
Street Address Address Line 2 City State ZIP Code
Purpose of Check (Be Specific)*

Expenses

Please complete the following for each expense that you are submitting. The location column is the store at which the expense was made. The Purpose column explains why the expense was made. The Category column should contain the ministry unit or the event for which the expense was made.

Date	Location	Purpose	Category	Amount
					Edit Delete
There are no Expenses.

Total Reimbursement Request
Copies of Receipts
Drop files here or

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 1 GB, Max. files: 20.
If you are missing one or more receipts, please explain.
Individual Making Request*
First Last
Phone*
Email*
Comments
This field is for validation purposes and should be left unchanged.