Check Request Form

CHECK REQUEST FORM

(use this form to request reimbursement for expenses)

Date Submitted:

To:

Treasurer, Lake Highlands Area Early Childhood PTA

From:

Date Check Needed:

Description of Item

Budget Category

Amount

Total for Check:

$____________

Please make check payable to:

NOTE: RECEIPTS MUST BE ATTACHED AND FUNDS STILL AVAILABLE IN THE

BUDGET BEFORE A CHECK CAN BE ISSUED. NO TAXES CAN BE PAID. PLEASE

USE SALES TAX EXEMPTION CERTIFICATE WHEN PURCHASING GOODS FOR

USE BY PTA.

For Treasurer’s Use:

Date Check Issued:

_____________________________

Check Number:

_____________________________

Budget Category:

_____________________________

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Parent category: Business