BTW PTSA Reimbursement or Check Request

PLEASE NOTE: As a sales tax exempt organization, we cannot reimburse sales tax, so please give all vendors a copy of our sales tax exemption form (EIN #:75-2143088) to avoid being charged sales tax when you make your purchase. Additional instructions:

Please fill out the form completely with description of reimbursement and breakdown of expenses.
Upload files/pictures/scans of all receipts and supporting documentation.
A receipt of your submitted request will be e-mailed to you. Please keep it for your records.
Please complete the form and submit receipts and/or invoices within 14 days.
Questions? Please e-mail our treasurer at btwhspvaptsa.treasurer@gmail.com.

*Entries marked with an asterisk are required.


Requestor Information
First and Last Name* Check Made Payable To:* Address (include street, city, state, ZIP)* Email* Phone* Are you a:* PTSA Member Parent Student Faculty Member Contractor Other If you chose other, please provide additional information.

Electronic Reimbursement (Optional)
ZELLE REIMBURSEMENT We are excited to now offer electronic reimbursement through Zelle! IMPORTANT: BTWHSPVA PTSA cannot be responsible for incorrect information provided on this form. Please first ensure you have an active Zelle account and confirm the information associated with your account prior to completing this section. Please provide the following information: Name associated with your Zelle account: Email address associated with your Zelle account: Phone number associated with your Zelle account:

Reimbursements Requested
Item 1* Item 1 Vendor* Item 1 Committee/Event* If you indicated other, please indicate the committee or event below: Item 1 Amount* Please upload the invoice or receipt for item 1.* Item 2 Item 2 Vendor Item 2 Committee/Event Item 2 Amount Please upload the invoice or receipt for item 2. Item 3 Item 3 Vendor Item 3 Committee/Event Item 3 Amount Please upload the invoice or receipt for item 3. Item 4 Item 4 Vendor Item 4 Committee/Event Item 4 Amount Please upload the invoice or receipt for item 4. Item 5 Item 5 Vendor Item 5 Committee/Event Item 5 Amount Please upload the invoice or receipt for item 5.

Total Reimbursement
Total amount requested for reimbursement/payment:

Additional Notes
Notes or comments for treasurer: