Utah Reimbursement form


 

Check Payable to:  

Address:  

City:  

Zipcode:  

Please use this Google Sheets link to calculate your costs for travel. 

ASPIRE Travel Resources 

ASPIRE uses GSA for per diem 

Itemized Description of Expenditure

Note: Attach original receipts or vendor invoice for all expenses 

Allowed file extensions are jpg, jpeg, jpe, gif, png, pdf (Please convert Excel files to pdf before uploading)

Description/Purpose of Expenditure:  

Item:

Date Incurred

Account Codes: (Please select from this list)  

Reimbursement Requested:  

Donation in Lieu of Request:  

After you complete this form, it will be sent to your State President and when they sign the form, it will be sent to the State Treasurer and finally the Regional Treasurer.

 

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: Utah Reimbursement form
lock iconUnique Document ID: 07244fb1877b42c18fca46977d6295ec7ca5567e
Timestamp Audit
May 10, 2023 9:15 am CSTUtah Reimbursement form Uploaded by Lori Larson - lori.larson@und.edu IP 165.234.101.71
May 10, 2023 9:17 am CSTKasha Farmer - kfarmer@uvu.edu added by Dennis Stangl - dennis.stangl@aspireonline.org as a CC'd Recipient Ip: 134.129.197.30
May 10, 2023 9:17 am CSTBrenda Olson - bolson@safmt.org added by Dennis Stangl - dennis.stangl@aspireonline.org as a CC'd Recipient Ip: 134.129.197.30
May 10, 2023 9:21 am CST Document owner dennis.stangl@aspireonline.org has handed over this document to kfarmer@uvu.edu 2023-05-10 09:21:43 - 134.129.197.30
May 10, 2023 9:21 am CSTKasha Farmer - kfarmer@uvu.edu added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
May 10, 2023 9:21 am CSTBrenda Olson - bolson@safmt.org added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
October 17, 2023 9:30 am CSTKasha Farmer - kfarmer@uvu.edu added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
October 17, 2023 9:30 am CSTBrenda Olson - bolson@safmt.org added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
October 18, 2023 11:22 am CSTKasha Farmer - kfarmer@uvu.edu added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 184.99.189.221
October 18, 2023 11:22 am CSTBrenda Olson - bolson@safmt.org added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 184.99.189.221
January 2, 2024 1:22 pm CSTLori Larson - lori.larson@und.edu added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
January 2, 2024 1:22 pm CSTBrenda Olson - bolson@safmt.org added by Kasha Farmer - kfarmer@uvu.edu as a CC'd Recipient Ip: 134.129.197.30
January 2, 2024 1:38 pm CST Document owner kfarmer@uvu.edu has handed over this document to lori.larson@und.edu 2024-01-02 13:38:49 - 24.10.163.160
January 2, 2024 1:38 pm CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 24.10.163.160
January 2, 2024 1:38 pm CSTBrenda Olson - bolson@safmt.org added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 24.10.163.160
October 9, 2024 8:14 am CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 134.129.197.30
October 9, 2024 8:14 am CSTBrenda Olson - bolson@safmt.org added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 134.129.197.30
October 9, 2024 8:29 am CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 134.129.197.30
October 9, 2024 8:29 am CSTBrenda Olson - bolson@safmt.org added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 134.129.197.30
August 15, 2025 3:06 pm CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.67
August 15, 2025 3:06 pm CSTBrenda Olson - bolson@safmt.org added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.67
October 7, 2025 1:46 pm CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.72
October 7, 2025 1:46 pm CSTBrenda Olson - bolson@safmt.org added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.72
January 6, 2026 11:48 am CSTLori Larson - lori.larson@und.edu added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.71
January 6, 2026 11:48 am CSTMike Aune - maune@workmosis.com added by Lori Larson - lori.larson@und.edu as a CC'd Recipient Ip: 165.234.101.71
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