AMERICAN ASSOCIATION OF UNIVERSITY WOMEN ARIZONA

EXPENSE CLAIM FORM

Fill out form, being sure to sign and date. Attach all receipts if available.

Mail or e-mail to: Margaret Horn, AAUW-AZ Treasurer

25854 South New Town Drive

Sun Lakes, AZ 85248

mhornteeup@robsoncom.net

Name of Applicant _____________________________________________

Office/Committee ______________________________________________

Description of Claim (attach receipts)

Budget item to be charged Date Cost

Telephone/FAX ________________________ ______ $_____

Printing (copies, etc.) ________________________ ______ $_____

Supplies (paper, etc.) ________________________ _______ $_____

Other (specify) ________________________ _______ $_____

SUBTOTAL $_____

Travel: Miles (round trip) x $.20/mile $_____

Date of Trip_________Passengers name(s) ____________________

Destination____________________ ____________________

Purpose_______________________ ____________________

TOTAL $_____

Make Check Payable to __________________________________________________

Address_________________________________________________________

City, State ZIP____________________________________________________

Applicant Signature ________________________________________________Date_________

Please remit within 30 days of incurring expenses. Any claim over 45 days old will NOT be paid.