Quarterly Expense Report

Please file this report on a quarterly basis.

October-December = 1st Quarter
January-March = 2nd Quarter
April-June = 3rd Quarter
July-September = 4th Quarter

Total District Lt. Governor reimbursement is limited to the amount budgeted for the fiscal year. Please limit reimbursement requests to one in-person club visit per year.

Keep all available receipts with your copy for tax purposes.
Digital copies may be uploaded with your online submission.

LTG Quarterly Expense

Lt. Governor Information

Name(Required)

First Last

Email(Required)

Division Name(Required)

Quarter Being Submitted(Required)

Travel To/From Clubs & District Meetings

Entries (Round trip, other than home club)(Required)

Date

Club/ District Meeting

Mileage

Use the “+” button to add another entry.

Total Miles Entered(Required)

Reimbursement Estimate ($0.315 per mile)

This estimate is based on a rate of $0.315 per mile.

Reimbursement Estimate ($0.60 per mile)

This estimate is based on a rate of $0.60 per mile.

Other Expense Items

Entries (Non-mileage expenses)

Date

Description

Amount

Use the “+” button to add another entry.

Supporting Documents

Supporting files to upload…

Complete documentation is needed for reimbursement. If you have problems with trying to upload files then email them to directly to [email protected]

Drop files here or

Max. file size: 100 MB, Max. files: 20.

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