Request for Cash Reimbursement

Department of Theatre & Dance

Use this form for easy (no more than 5 line items) reimbursements for academic or production expenses.  For more complicated requests please work with Jacob directly.

Guidlines for receipts - Must be standard sheet of paper sized and PDF.  If you are starting from a credit card receipt please tape it to a regular piece of paper before scanning.  If it is too long to fit it is acceptable to cut it into pieces and tape them side-by-side. If the receipt was electronic to start with be sure to retain your copy.  If it was a physical receipt be sure to put it into Jacob's box after you scan and upload it. 

Date/Time*
Name of Claimant (who are we paying)*
Name of Preparer (who's filling this form out)*
$
$
$
$
$
$
Calculated
No File Chosen
File uploads may not work on some mobile devices.
Upload as ONE SINGLE document (with many pages if necessary
What is this for, etc.
Is the claimant available to sign right now?*
Greatly speeds up processing time
Use your mouse or finger to draw your signature above
Is the claimant faculty/staff?

Claimant Review

If Any
Do you agree to sign?
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Approver Review

Date/Time*
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