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Webster UCC Request for Payment
Reimbursement, Payments, Debit Card Use.
This form replaces the Pink Slip and Blue Slip paper forms.
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
Today's Date
*
MM
/
DD
/
YYYY
Debit card
Yes, charged to church debit card
Dollar amount
*
Your answer
Date payment is due (or date of debit card transaction)
MM
/
DD
/
YYYY
Name of payee (payable to)
*
Your answer
Address of payee
Your answer
Description of expense
*
Your answer
Expense Category
*
Choose
Mission - Community outreach, 5-for-5 offerings, Pet Food Pantry, etc.
Congregational Life - Events, coffee hour, new members, summer concerts
HR - Substitute minister, mileage, professional expenses
Worship - Communion, Candles, Music, etc.
Spiritual Nurture - Children & Youth programs, VBS, Small group resources
Finance
Building & Grounds
Office
Multiple Categories - expense is split among 2 or more of the above categories
If multiple expense categories, enter the amounts for each category here along with category names
Your answer
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