Florida LMSC Reimbursement Voucher

Instructions

Reimbursement Information

Requester Name

Address

 City, State zip

Check Payable To
(if different from above)

 

Address

 

 City, State zip

General Expenses

*Travel 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

 $

       

*Travel Expenses:
Hotel reimbursement is for one half (1/2) of the basic event room rate with a maximum of five nights, (Normally 4 nights for convention.)
Food subsidy - the lesser of $20/day or $100/convention. $25/day - other events.
Travel expenses include car ($.30/mile if you drive your own, or economy rental), plane at coach rate, airport shuttle, etc. Receipts required, except for food.

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

 Total reimbursement requested

 $   Signature

Mail to:

Nancy Kryka
Treasurer, Florida LMSC
5452 Manchini St
Sarasota, FL 34238
 OFFICE USE ONLY
Budget item:
Date / Year:
Explanation: