Sample Reimbursement Voucher -- Appendix H

NCTE Committee And Project Reimbursemet Voucher

Name_____________________________________________  Date_____________
Address_____________________________________________________________
____________________________________________________________________
City ______________________________ State _____ Zip ____________________
Committee or Project__________________________________________________
Role in Connection with Committee or Project______________________________

ITEMIZED EXPENSES

1.  Postage                                                     $ _____________
2.  Express Mail                                              $______________
3.  Printing                                                      $______________
4.  Copying                                                     $______________
5.  Secretarial/Clerical Services                        $______________
6.  Telephone & Fax Charges                           $______________
7.  Supplies                                                    $______________
8.  Other (please itemize below)
    description _____________________ amount $______________
    description _____________________ amount $______________
    description _____________________ amount $______________
    description _____________________ amount $______________
 
9.  Total Expenses                                           $______________
 
I certify that all of the expenses on this form were incurred in the course of NCTE business and are valid business expenses for NCTE.________________________
 
Committee Chair or Liaison Officer_______________________________________
 
Business Director_____________________________________________________