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ASSOCIATION OF BANKRUPTCY JUDICIAL ASSISTANTS
PLEASE READ EXPENSE REIMBURSEMENT POLICY AND PROCEDURES BEFORE COMPLETING FORM
http://www.abja.org/content/expense-reimbursement-policy
Please confirm
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I have read the reimbursement policy
This request for reimbursement is for expenses incurred in connection with:
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Certified Bankruptcy Assistant Program
Professional Skills Seminar
Official ABJA Business
While participating as a
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Member
Speaker/Presenter
If related to a conference, please provide the city and state of the conference
PLEASE MAKE CHECK PAYABLE TO (Complete all contact information)
First Name
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Last Name
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Street Address
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Address Line 2
City, State and Zip Code
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Phone Number
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Email Address
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Airfare
Hotel
Ground Transp.
Parking
No. of POV Miles
No. Miles x 0.560
Date
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Breakfast
Lunch
Dinner
Date
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Breakfast
Lunch
Dinner
Date
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Breakfast
Lunch
Dinner
Date
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Breakfast
Lunch
Dinner
Misc. Expense Description
Amount
Misc. Expense Description
Amount
Total
0.00
Calculate
Comments:
Upload Receipt(s). Please combine receipts so there are no more than three files uploaded.
Submitted by
/s/ Electronic Signature (by typing name)
Title (officer/committee chair/speaker)
Date
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