MU IOTA CHAPTER

Reimbursement Request Form

Reimbursement Procedure

Expense must be pre-approved by the Executive Committee with original receipts.
Complete this form with all required information.
Attach documentation (receipts or written explanation).
Submit to Keeper of Finance within 30 days of expense.
Keeper of Finance reviews; Executive Committee approves/denies within 14 days.
Reimbursement issued within 14 days of approval via Check, Zelle, PayPal, or Other.

Member Full Name

Contact Info (Phone/Email)

Event Name

Date of Expense

Amount of Expense

Date of Request

Original receipts attached?

YesNo

Explanation provided if no receipts?

YesNoN/A

Explanation

Upload Receipts

Accepted: JPG, PNG, HEIC, PDF — multiple files allowed. Images are automatically optimized before sending.

📎

Click to upload or drag & drop receipts here

Images & PDFs accepted

CheckZellePayPalOther

Method Details (username, email, mailing address, etc.)

This section is completed by the Keeper of Finance and Basileus after submission.

Checklist Item	Yes/No
Form fully completed	—
Expense aligns with approved activity	—
Submitted within 30-day window	—
Receipts or proof included	—
Executive Committee approval received	—

Keeper of Finance: ________________ Date: ______

Basileus: ________________ Date: ______