Expense Receipt Upload Form
Any reimbursements must be uploaded into Paylocity
Staff Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Receipt Total
*
REASON- Please describe below, if needed
Cleaning/ Cleaning Supplies
Client(s) Entertainment: Not Food
Client(s) Entertainment: Food
Groceries
Utilities
Office Supplies
Auto: Gas
Auto: Service
Continued Learning
Parking
Transportation
Furniture or things to set up a unit
Medical
Property repairs
Groundskeeping
Client: Moving Expenses
Other
CRS Sites
Please Select
Elliot: 9213 Elliot Ave S, Bloomington
13th: 9230 13th Ave S, Bloomington
4th: 6604 4th Ave S., Richfield
Clinton: 3552 Clinton Ave, Minneapolis
12th: 609 12th St., Newport
ICS Site
Please Select
Isabel: 71 Isabel St. W, Saint Paul
Oakland: 2636 Oakland Ave S, Minneapolis
Lyndale: 9130 Lyndale Ave S, Bloomington
Logan: 9800 Logan Ave S, Bloomington
O.S.: 5014 W Old Shakopee, Bloomington
26th: 1912 E. 26th St, Minneapolis
11th: 3517 11th Ave S, Minneapolis
14th: 3223 14th Ave S, Minneapolis
2112: 2112 Elliot Ave S., Minneapolis
Midtown: 2521 Bloomington Ave, Minneapolis
BLF: 3020 16th Ave, Minneapolis
Newport: 2300 Hastings Ave, Newport
Other (Market, Commercial, Corp Housing)
Please Select
Office: 2001 W 94th, Bloomington
Office 2: 8053 E. Bloomington Fwy, Bloomington
22nd: 3626 22nd Ave, Minneapolis
25th N: 1008 25th Ave N, Minneapolis
25th S: 2536 25th Ave S., Minneapolis
Arcade: 1047 Arcade, Saint Paul
MLL: 3640 23rd Ave S., Minneapolis
Corp Housing: Apartments at MLL
Corp Housing: 2537 11th Ave S, Minneapolis
Corp Housing: 19 Sidney Place, Minneapolis
Corp Housing: 2300 Hastings Ave
Corp Housing: 9130 Lyndale Ave, Bloomington
Cluster, if specific to the whole cluster
Please Select
Cluster 1
Cluster 2
Cluster 3
Cluster 4
Cluster 5
receipt will be split equally on all sites within cluster
Apartment #
PROGRAM EXPENSES (specific to the whole program and not a site or unit)
Intervention Services
Grant Projects
Supportive Housing
ICS
CRS
TCM
Other
Information about purchase:
Other important information related to the purchase or if a split is not equal, amount of split needed.
File Upload- write why/ site or cluster on top of the receipt
*
Browse Files
Drag and drop files here
Choose a file
Please upload a clear picture of the receipt.
Cancel
of
Submit
Should be Empty: