Expense Reimbursement Request

Attach all your receipts prior to submitting the form. If you have issues uploading receipts, you may email them to reimbursements@nrcoc.com or turn them into the Admin Office.

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Please Note: This form can ONLY be filled out for one Ministry (Cost Center) expenses. If your expenses cover multiple ministries, please fill out a separate Expense Reimbursement form for each ministry.

Date of Request: * +

Date Payment Needed: * +

Delivery Method *

Deliver how? *

Form Status (do not update!) * 🛈

Make Payment To:

Company Name or Individual's Full Name (First Last) *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number * 🛈

FOR Ministry Leaders ONLY! Are you submitting this reimbursement for the same Ministry you do Ministry Approvals for? *

No

Yes

Expense Details

Please Note! If this is a Special Event where the event income is collected via registration and expenses are paid out, like a retreat, PLEASE only use the 'SPECIAL EVENTS' Ministry Expense Type when entering your expense items below.

Ministry/Cost Center *

1-Ministry Expense Type *

1-Congregational Expense Type *

1-Administration Expense Type *

1-Missions Expense Type *

1-Buildings & Grounds Utilities Expense Type *

1-Repairs & Maintenance Expense Type *

1-Capital Expense Type *

1-Communities Expense Type *

1-Description (Include Purpose of Purchase and Names of Attendees if Under 10) *

1- Date of Activity or Date of Purchase For Non-Activity Purchases * +

1- Number of People in Attendance (please include names in the description if Under 10) *

1-Amount *

1-Receipt? *

1-Provide Explanation if No Receipt: *

Attach Receipt 1 *

2-Ministry Expense Type

2-Congregational Expense Type

2-Administration Expense Type

2-Missions Expense Type

2-Buildings & Grounds Utilities Expense Type

2-Repairs & Maintenance Expense Type

2-Capital Expense Type

2-Communities Expense Type

2-Description (Include Purpose of Purchase and Names of Attendees if Under 10) *

2- Date of Activity or Date of Purchase For Non-Activity Purchases * +

2- Number of People in Attendance (please include names in the description if Under 10) *

2-Amount *

2-Receipt? *

2-Provide Explanation if No Receipt: *

Attach Receipt 2

3-Ministry Expense Type

3-Congregational Expense Type

3-Administration Expense Type

3-Missions Expense Type

3-Buildings & Grounds Utilities Expense Type

3-Repairs & Maintenance Expense Type

3-Capital Expense Type

3-Communities Expense Type

3-Description (Include Purpose of Purchase and Names of Attendees if Under 10) *

3- Date of Activity or Date of Purchase For Non-Activity Purchases * +

3- Number of People in Attendance (please include names in the description if Under 10) *

3-Amount *

3-Receipt? *

3-Provide Explanation if No Receipt: *

Attach Receipt 3

4-Ministry Expense Type

4-Congregational Expense Type

4-Administration Expense Type

4-Missions Expense Type

4- Communities Expense Type

4-Buildings & Grounds Utilities Expense Type

4-Repairs & Maintenance Expense Type

4-Capital Expense Type

4-Description (Include Purpose of Purchase and Names of Attendees if Under 10) *

4- Date of Activity or Date of Purchase For Non-Activity Purchases * +

4- Number of People in Attendance (please include names in the description if Under 10) *

4-Amount *

4-Receipt? *

4-Provide Explanation if No Receipt: *

Attach Receipt 4

5-Ministry Expense Type

5-Congregational Expense Type

5-Missions Expense Type

5-Administration Expense Type

5-Buildings & Grounds Utilities Expense Type

5-Repairs & Maintenance Expense Type

5-Capital Expense Type

5- Communities Expense Type

5-Description (Include Purpose of Purchase and Names of Attendees if Under 10) *

5- Date of Activity or Date of Purchase For Non-Activity Purchases * +

5- Number of People in Attendance (please include names in the description if Under 10) *

5-Amount *

5-Receipt? *

5-Provide Explanation if No Receipt: *

Attach Receipt 5

Total Reimbursement Amount:

$0.00

Person Placing this Request: *

Your Email Address *

Enter your Email Again *