Sample Expense Voucher Form printable pdf download

SAMPLE EXPENSE VOUCHER FORM

(Current)/Business_Expenses_and_Reimbursement/Accountab

le_Reimbursement_Policies/Sample_Expense_Voucher.pdf

Set forth below is a sample voucher form that can be used to record information relating to business

purchases for the church. The form can be used to request payment or reimbursement for church-related

items bought by a member of the church, such as paper plates for the church kitchen, cleaning supplies, or

a new electrical switch for the parsonage. The form can also be used by a staff person to request payment

or reimbursement of expenses pursuant to an accountable reimbursement plan.

Direct Payment Example: The choir director may be requesting direct payment of some continuing

education expense that is part of his/her accountable reimbursement plan. The director would complete

the form, attach the invoice or bill, preferably the original, obtain the necessary authorization (i.e.,

signature of person authorized to approve the expense), and submit the completed form to the treasurer

for payment. The choir director should keep a copy.

Reimbursement Example: The pastor purchases and pays for a new robe. He/she would complete the

form, asking that reimbursement be made to him/her for purchase of vestments and would attach the

original or a copy of the receipt. The necessary authorization signature is obtained and the completed

form is submitted to the treasurer for payment. The treasurer would remit the amount to the pastor. The

pastor should keep a copy.

In each case, it will simplify the treasurer’s job if the person submitting the voucher notes the account

number or budget line item number.

“CHURCH NAME”

Expense Voucher

Date: _________________________

Amount: $ _______________________

Pay To:

Name ______________________________________________________________________

Address ____________________________________________________________________

Description of Expense: ______________________________________________________________________

Business Purpose of Expense: _________________________________________________________________

Receipt/Bill:

Attached

Account Number or Budget Line Item Number: ___________________________________________________

Person Requesting Payment: __________________________________________________________________

Approved By: ______________________________________________________________________________

Special Instructions: _________________________________________________________________________

Sample Expense Voucher Form