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   Reimbursement/Prepaid Expense Voucher

This form must be completed any time reimbursement is requested for expenses incurred and/or prepaid expenses (i.e. registration fees, etc.).  Please refer to the guidelines when completing.  Please complete, print, and mail the following form to:

One Stop - Bethany Vincent
NDASFAA Treasurer
Dept 2836 PO Box 6050
Fargo ND 58108-6050

From:

Re:  (Please check the appropriate section--check both, if needed):


Reimbursement for expenses incurred.
Prepayment of required expenses.

Date(s) of incurred expenses:

Committee or Activity:

Itemized List of expenses (appropriate documentation attached):

Please make check payable to:

Mail check to:

City

State

Zip

Submitted by: ______________________________________________
Date:____________________

Approved by: ______________________________________________
Date:____________________

Second Approval*:______________________________________________
Date:____________________
(*Required only if Treasurer submits a voucher)

NDASFAA Check #:_____________
Amount of Check:___________
Date:___________