Old Orchard PTA
Reimbursement Voucher
PART I – To be completed by Individual Submitting Voucher
Line Item (Event Name): ____________________________________________________________
Item Descriptions Purchase Date Vendor Cost
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
Invoices and Receipts Must be Attached
Printed Name: ____________________ Signature: ____________________ Date: _______________
PART II – To be completed by the PTA President, Vice President, or Treasurer
Authorizing Signature: _____________________________________________ Date: _______________
Title (circle one): President Vice President Treasurer
PART III – To be completed by the PTA Treasurer
Amount Reimbursed: __________ Date of Reimbursement: ____________ Check Number: ______
Reimbursement Voucher
PART I – To be completed by Individual Submitting Voucher
Line Item (Event Name): ____________________________________________________________
Item Descriptions Purchase Date Vendor Cost
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
________________________________ ______________ __________________ ___________
Invoices and Receipts Must be Attached
Printed Name: ____________________ Signature: ____________________ Date: _______________
PART II – To be completed by the PTA President, Vice President, or Treasurer
Authorizing Signature: _____________________________________________ Date: _______________
Title (circle one): President Vice President Treasurer
PART III – To be completed by the PTA Treasurer
Amount Reimbursed: __________ Date of Reimbursement: ____________ Check Number: ______