Red Cedar Zen Community - Finance Reimbursement Form

Red Cedar Zen Community

PO Box 5193

Bellingham, WA 98227

Reimbursement Request Form

Date:________________

Name:________________________________ Signature: ____________________________

Mailing Address:________________________________________________________

Phone Number:__________________________________________________________

Date of expenditure:______________________________________________________

Purpose/Event:__________________________________________________________

Please list the item and amounts below and attach all receipts.

ITEM AMOUNT

____________________________________________________________________________

TOTAL $_______________

OFFICE USE ONLY:

Payment Acct __________ Transaction# _________ Amount __________ Date ____________ Initials _________

Record Category _____________ Transaction# ____________ Date ____________ Initials ___________

Red Cedar Zen Community