Expense Voucher for Concert Performance Assessment – South Carolina Band Directors Association

Use this form to submit an expense voucher for the Concert Performance Assessment event.

CPA Site Location(Required)

Please select the CPA Site Location for this voucher.

I am a...(Required)

CPA Adjudicator

SCBDA Worker/Member

Site Host

I am seeking reimbursement for:(Required)

Check all that apply.

Mileage

Other Expenditures

Travel Expenses

Automobile Travel FROM(Required)

Automobile Travel TO(Required)

Enter the number of ROUND TRIP miles.(Required)

SCBDA Mileage Rate: .37 per mile. Round-trip mileage is capped at $50.00. Please complete the form with all the pertinent information, understanding that mileage will be capped at $50.00.

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Mileage Rate(Required)

Please enter a number from 0.37 to 0.37.

Mileage Price(Required)

Price: $0.00

Enter the number of ROUND TRIP miles.(Required)

SCBDA Mileage Rate for CPA Adjudicators: .58 per mile.

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Mileage Rate(Required)

Please enter a number from 0.58 to 0.58.

Mileage Price(Required)

Price: $0.00

Mileage Cap Max

Price:

Other Expenses

Additional Expenditure 1(Required)

Enter a description of the expense.

Amount 1(Required)

Enter an amount for this expense.

Additional Expense 1 Receipt(Required)

Please upload a receipt for this expenditure.

Accepted file types: jpg, png, tiff, pdf, heic, Max. file size: 5 MB.

Do you have any other eligible expenditures?(Required)

Yes

Additional Expenditure 2(Required)

Enter a description of the expense.

Amount 2(Required)

Enter an amount for this expense.

Additional Expense 2 Receipt(Required)

Please upload a receipt for this expenditure.

Accepted file types: jpg, png, tiff, pdf, heic, Max. file size: 5 MB.

Do you have any other eligible expenditures?(Required)

Yes

Additional Expenditure 3(Required)

Enter a description of the expense.

Amount 3(Required)

Enter an amount for this expense.

Additional Expense 3 Receipt(Required)

Please upload a receipt for this expenditure.

Accepted file types: jpg, png, tiff, pdf, heic, Max. file size: 5 MB.

Requester's Information

The check should be made payable to:(Required)

The check should be mailed to:(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Please provide your e-mail address should we have a question during processing this voucher.

Phone(Required)

Please provide your phone number should we have a question during processing this voucher.

Total

Total Reimbursement Request