Great Oak Reimbursement Form

We need to keep records of purchases. Please fill this out and attach a copy of receipts to it when asking for reimbursements from the GOCA Check writer or the Meals biller (make sure you pick "Meal program cooking shopping" account if it is for meals).

You may fill this out and print it to submit with your receipt to the check writer, or if you have a copy of your receipt to attach, you can submit it online and it will be sent by email to the check writer with a copy cc'd to you. if you prefer you can print out the paper reimbursement form or the older reimbursement form.

Your name
Unit #
Date of purchase
Your email address
What purchased (write "check request" for a check)
Who purchased from
Amount of purchase $
reimbursement by (only meals can be reimbursed by "credit")	check credit
Account to be debited
comments
attach receipt (2MB max)
	or
just testing?