PNACAC Reimbursement Form

All requests must be submitted within 30 days of the event or the date of expenditure, whichever is later.

1. Determine which expenses are eligible for reimbursement.

- If you're a scholarship or grant recipient, reference the scholarship/grant notification letter, which should outline which expenses are reimbursable.
- If you're a Board member, reference the reimbursement chart in the Policies and Procedures Manual.

2. Gather your receipts for every item and scan/take photos of them. PNACAC is unable to reimburse for an expense without a receipt or other proof of purchase.

3. Complete the Reimbursement Form and submit a combined PDF of all receipts (Merge PDF tool). Committee Chairs will automatically receive a copy of requests that require their approval. For Scholarship Recipients, the Committee Chair is likely the person who signed your notification letter.

4. You’re done! Over the next two weeks, PNACAC will review your request and be in touch with questions, if necessary. The PNACAC Treasurer will then notify you of its final approval and an approximate date by which you will be reimbursed.

If you have any questions before submitting this form, contact admin@pnacac.org. If questions arise after the Treasurer has approved your reimbursement, contact the Treasurer directly at treasurer@pnacac.org.

Submitter First Name

Submitter Last Name

Submitter Email Address

Submitter Phone

Are you submitting this reimbursement form on behalf of someone else?
If they are your expenses, but the funds are being reimbursed to someone else (e.g. your institution) please select Yes.

No, this reimbursement is for me

Yes, I am submitting this reimbursement for someone else

Reimbursement Information

Payee Name (full name of person or organization the check should be made out to)

Payee Email

Payee Phone

The person receiving reimbursement is a(n):

PNACAC Committee

Other Committee

Scholarship Received

Other Role

What is the preferred method of reimbursement?

ACH

Mailed Check

Mailing Address

Country

Street

City

Region

Postal Code

Brief description of reimbursement

First day of reimbursement

Last day of reimbursement

Reimbursement Expense Types

Meals

PNACAC will reimburse up to the federal daily Meal & Incidentals (M&IE) Rate for the city in which the event occurred. Meals provided as part of a conference or event are not eligible for reimbursement. Receipts are not required.

To determine the maximum M&IE rate:

1. First, go to the GSA.gov per diem search to determine the federal per diem rate for the ZIP code to which you traveled.

Example of a M&IE rate:

2. Enter the ZIP code you used to search

3. Enter the MI&E Rates from the website

MI&E Total Rate

MI&E Breakfast Rate

MI&E Lunch Rate

MI&E Dinner Rate

MI&E Incidentals Rate

4. Finally, enter the number of each meal type that you are seeking reimbursement for. (Don't forget, you can only seek reimbursement for meals you paid for out of pocket.)

Breakfast Count

Lunch Count

Dinner Count

Total days of M&IE reimbursement

Automatically calculated from trip dates above, using 0.75 for travel days (first and last days of travel).
For example, three days of travel calculates as: 0.75 + 1 + 0.75 = 2.5

Total for meal reimbursement (feel free to lower this amount if you'd like to request a lower meal reimbursement)

Calculated using the count of meals, at the rates provided, plus the incidental cost rate per travel day.

You may not request more than the maximum allowed amount.

Lodging

PNACAC will reimburse up to the federal daily Lodging Rate for the city in which the event occurred OR the rate of lodging required for a conference or event. Lodging receipts ARE required.

Enter the Lodging Daily Rate

Total Nights of Lodging

Total for Lodging Reimbursement

Transportation

Airfare

Airfare total

Personal Car Mileage

Use of your personal vehicle for PNACAC business is reimbursable at 67 cents per mile. In lieu of a receipt, provide an image of your roundtrip route (from Google Maps, Apple Maps, or a similar service) as documentation of miles driven. PNACAC does not reimburse fuel costs for personal vehicles.

Miles Driven

Mileage Reimbursement Amount

Other Transportation

Total cost of other transportation

Provide a description. Examples: Rideshare, Rental Car, Taxi, Bus, Train

Miscellaneous Transportation Expenses (optional)

Examples: Checked bags, parking, etc.

Total cost of misc. transportation expenses

Provide a description

Conference / Event Registration

Total cost of registration

Provide the name of the conference or event

Miscellaneous Expenses

Total cost of miscellaneous expenses

Provide a description of misc. expenses

Reimbursement Summary

This amount may change after the PNACAC Treasurer reviews all documentation. An explanation will be provided if this total is different.

Additional Comments

Receipt Upload

You will need documentation for the items below

The checkboxes below are simply a visual tool to mark off items as verification that you have included them in your attached document.

You will need documentation for the items below

The checkboxes below are simply a visual tool to mark off items as verification that you have included them in your attached document.

Lodging Receipt(s)

Airfare Receipt(s)

Personal Car Mileage Map(s)

Other Transportation Receipt(s)

Misc. Travel Receipt(s)

Conference / Event Registration Receipt(s)

Misc: Postage, Printing, Office Supplies, Other Receipt(s)

Upload receipts and/or proof of payment here

Combine all receipts into one PDF, please! | Merge PDF tool