Full Text
City of Missoula Neighborhood Request for Reimbursement Form PART 1 Part 1--to be completed by Neighborhood volunteer requesting reimbursement. Please submit receipts with this form to: Office of Neighborhoods, 435 Ryman, Missoula, MT 59802 or e-mail the form and receipts to [EMAIL REDACTED]. SUBMIT RECEIPT WITH NEIGHBORHOOD ITEMS ONLY (NO PERSONAL ITEMS ON RECEIPT) Neighborhood Council: Make check payable to: Address to send check to: Total amount to be paid: Purpose of purchase(s): Brief description of purchase(s): State of Montana, ) ss. County of Missoula ) I certify: ~that this request for reimbursement is correct and just in all respects ~ that my neighborhood council leadership team has approved these expenditures in accordance with our Neighborhood Council bylaws. ~ that I have not already received payment or credit. Your Printed PART 2 Part 2 - for City use only Invoice 1000 General Fund Dept. Account Amount Dept.