Florida LMSC Reimbursement Voucher

Instructions

• Type the required information into each box
• Then, print this form, sign it, attach receipts, and mail it to the address below. Attach all receipts before mailing! You will not be reimbursed without receipts except for the convention food subsidy.
• If there is more than one receipt per expense item, list each receipt in the Itemized expenses box.
• Place the TOTAL AMOUNT per category in its Amount column.
• Add those totals and type this total in the Total reimbursement requested box.

Reimbursement Information	requester name
	address
	city, state zip
check payable to (if different from above)
	address
	city, state zip

General expenses			*Convention expenses
Expense type	Amount	Itemized expenses	Expense type	Amount	Itemized expenses
Postage/mailing	$		Registration	$
Printing/copying	$		1/2 Hotel	$
Office supplies	$		Food subsidy	$
Other (itemize)	$		Travel	$

*Convention expenses:

Hotel reimbursement is for one half (1/2) of the basic convention room rate with a maximum of five nights. Food subsidy is the lesser of $10/day or $50/convention Travel expenses include car ($.30/mile if you drive your own, or economy rental), plane at coach rate, airport shuttle, etc.

I hereby submit this request for reimbursement of expenses incurred by me on behalf of the Florida LMSC
Total reimbursement requested	$	signature

Mail to: Meegan Wilson Treasurer, Florida LMSC 620 NW 27th Way Gainesville FL 32607	OFFICE USE ONLY
	Budget item:
	Date / Year:
	Explanation: