IRC Republican Executive Committee (REC) Request for Check Reimbursement

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Please fill out this form for all reimbursements of expenses made on behalf of the IRC REC. Once approved a check will be mailed to the name and address you provide below.

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Email Address *

Please enter your email address and double check that it's correct.

First Name *

First name of person submitting request

Last Name *

Last name of person submitting request

Date of expenditure *

Select the date expenses were incurred or invoice date.

YYYY

Check payable to: *

Enter the name the check should be made out to.

Phone number *

Please enter the phone number of the person or entity receiving this reimbursement. Please enter number in xxx-xxx-xxxx format.

Account Number *

Enter the REC Account number or Invoice Number if applicable. Otherwise, enter N/A.

Street *

Street address where the check will be mailed.

City *

City where the check will be mailed.

State *

State where the check will be mailed.

Zip *

Zip code where the check will be mailed.

Purpose of Expense *

Please enter a brief description of expenditures. Please include the NAME of the fundraiser associated with this expenditure if applicable.

NOTE: All invoices a/o receipts must be emailed to Treasurer@IRCGOP.com or submitted in person to the REC Board (preferably the Treasurer).

Expense Type *

Select the classification for expenditures.

Special Event / General Fundraiser

General Merchandise

Office supplies, postage, misc

HQ operations (Internet, Rent, Insurance, Tech Spt, Website, REC Assets, etc.)

Other:

Amount *

Please enter the amount to be paid or estimated amount to be approved. Do NOT enter $. Amount must match receipts or invoice if you have them.

Invoices / Receipts *

Please indicate how your receipts were submitted so your request may be reviewed for approval.

Emailed copies to Treasurer@ircgop.com and/or Chairman@ircgop.com.

Dropped copies off at the REC HQ or submitted to an REC Board member.

I don't have an invoice or receipt yet. I'm requesting a pre-approval.

Other:

Submit

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