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District-Section Financial Transaction Form
Region
(Required)
Dist 01
Dist 02
Dist 03
Dist 04
Dist 05
Dist 06
Dist 07
Dist 08
Dist 09
Dist 10
Dist 11
Dist 12
Sect 01
Sect 02
Sect 03
Sect 04
Sect 05
Date
(Required)
MM slash DD slash YYYY
Transaction Type
(Required)
Revenue
Expenditure
Category
(Required)
Speech
Theatre
Middle Level
Debate
Administrative
Expenditure Information
Expenditure Type
(Required)
Contractor
Mileage
Expense
Select all that apply.
Payable Entity/Contractor
(Required)
This form can only be completed once per person/entity to whom reimbursement is being made. Complete the form separately for separate entities.
Email
(Required)
Used to send invitation for contractor to register electronically, including online completion of W-9 form. Payments will not be issued until that is received.
Contractor phone
(Required)
So we can contact contractor with questions
Honorarium description
(Required)
Brief description of services rendered by contractor.
Contractor Honorarium
(Required)
Please enter a number greater than or equal to
0.01
.
Expense description
(Required)
Expense(s) to be reimbursed.
General Expense Amount
(Required)
Please enter a number greater than or equal to
0.01
.
Starting Address
(Required)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Honorarium payments will be sent to the address registered with the state office by the contractor; this is simply to indicate mileage reimbursement starting/return point.
Roundtrip Mileage
(Required)
Please enter a number greater than or equal to
1
.
Please be sure this is
roundtrip
mileage, as calculated by starting destination and WHSFA event, and multiplied by two. Stops outside the most direct route (except for construction/detours) should not be counted.
Rate
WHSFA approved mileage reimbursement rate
Mileage Amount
Receipt(s)
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB.
Expenditure Total
Revenue Information
Paid by
(Required)
Name(s)/entity(ies) payment received on behalf
Brief description
(Required)
What payment is for
Payment Amount
(Required)
Please enter a number greater than or equal to
0.01
.
Notes
Invoice
Open
Paid
Vendor
Contract
Check Issued
MM slash DD slash YYYY
Check No.