Online Assembly Voucher Form

Assembly Expense Voucher
In order to be eligible for Travel Expense reimbursement, your name must appear on the assembly sign-in sheets.

Name & Meeting Attended

Contact Information

Mailing Address *
Mailing Address
City
State/Province
Zip/Postal

Travel Expenses

$
$

Contribution

Please deduct from the total travel expense the following sum, which I am hereby making as a contribution to the Presbytery of Ohio Valley.
(The amount of your contribution will be included on your year-end giving statement.)
$

Reimbursement

If you are donating any of your expenses, add the amount in the "Contribution" field above.
$
- $
$
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