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NCRSP District 9 Retired School Personnel
Patricia Perkins 1641 Surl Mt. Tirzah Rd.
Timberlake, N.C. 27583 336-364-2346
EXPENSE VOUCHER
Date submitted ______________________
Check Payable to ___________________________________
Address __________________________________________________________________
Street/Box City Zip
Position in District 9 RSP ______________________________________
Please attach receipts for items to be reimbursed
Description of request _______________________________________________________
Amount requested __________________
Signature of Claimant ___________________________________
Please check odometer for mileage
Miles traveled round trip __________ Amount ($.41 per mile) _____________
Reason for travel ______________________________________________
For Treasurer's use only
Amount paid _______________ Check # _____________ Date Paid ____________
Signature _______________________________________________
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