Occupy Berkshires Expense Voucher Form

12/15/2011
The sample voucher form below can be used for reimbursement of related expenses for
Occupy Berkshires. A member of a workgroup can use the form to request a direct payment or
reimbursement for purchase of related items, such as copies, speaker honorarium or rentals.
This form is to be used for expenses up to !"" per month per workgroup. A member should
use the voucher to request direct payment or reimbursement of expenses pursuant to the
proposal agreed to on !#$!!$!!, which states that the %inance group can approve up to !""
per month per workgroup without the &A's approval( amounts above !"" would require
approval at the &A. All groups should report financial activity each week as part of their
workgroup report.
Reimbursement Example: The bookkeeper purchases software. )e$she would complete the
form, asking that reimbursement be made to him*her for purchase of materials and would
attach the original receipt. The requester submits the completed form, via email, to the
treasurer for payment. The treasurer would remit the amount to the +,ay To- information on
the form and retains a copy.
,lease email completed form below to finance.occupyberkshires.com
Occupy Berkshires
Expense Voucher
Date: Amount: $
Pay To: Name
Address
Description of Expense:
Purpose of Expense:
Receipt/Bill: Attached No
Group Name:
Person Reuestin! Payment:
Appro"ed By:
#pecial $nstructions: