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Outing Reimbursement Request
How to Fill Out CASA Forms – 101
Please submit all expenses you may have for the month when filling out the request for reimbursement.
CASA SUPPORT COUNCIL FOR PIMA COUNTY, INC.
* Click Submit below when finished with the form.
DATE
*
MM slash DD slash YYYY
YOUR NAME
*
YOUR CASA EMAIL ADDRESS
*
YOUR PHONE
*
MONTH COVERED
*
(No more than 3 months from date of expenditure ie. Nov, Dec, Jan):
NUMBER OF CHILDREN:
*
$50.00 for each CASA child and $50 for CASA allowed monthly- example - 2 children and 1 CASA = $150 allowed.
Click on the "+" to add more lines.
*
DATE
AMOUNT
Click on the "+" to add more lines.
TOTAL REIMBURSEMENTS REQUESTED BY CASA: $
*
*For clothing or other non-outing reimbursements please submit a separate reimbursement receipts form.
UPLOAD RECEIPTS
Drop files here or
Select files
Max. file size: 256 MB.
Certification of Reimbursement Receipts
*
I certify that the above amounts are correct and are directly related to the completion of duties performed as a CASA or to benefit the CASA Program.