Expense Receipt Upload Form
Reimbursements must be uploaded into Paylocity
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
TYPE/ REASON/ CLASSIFICATION- (Please describe further below, if needed)
Cleaning/ Cleaning Supplies
Client(s) Entertainment: Not Food
Client(s) Entertainment: Food
Utilities
Office Supplies
Auto: Gas
Auto: Service
Continued Learning
Parking
Transportation
Furnishings
Medical
Other
LOCATION: CRS Program
ELLIOT: 9213 Elliot Ave S
4TH: 6604 4th Ave S
13TH: 9230 13th Ave S
MBC: 3552 Clinton Ave S
12th: 609 12th St., Newport
Other
LOCATION: ICS Program
ISABEL: 71 Isabel St W
26TH: 19 E 26th St S.
MIDTOWN: 2521 Bloomington Ave
11TH: 3517 11th Ave S
LYNDALE: 9130 Lyndale Ave S
ELLIOT: 2112 Elliot Ave S
LOGAN: 9800 Logan Ave S
14TH: 3223 14th Ave S
OLD SHAKOPEE: 5014 W Old Shakopee
OAKLAND: 2636 Oakland Ave S
NEWPORT: 2300 Hastings Ave
BLF
Other
PROPERTY EXPENSES
4th: 6604 4th Ave S
MBC: 3552 Clinton Ave S
ELLIOT: 9213 Elliot Ave S
13th: 9230 13th Ave S
12th: 609 12th St., Newport
OFFICE: 8053 E Bloomington Fwy
OLD SHAKOPEE: 5014 W Old Shakopee
LOGAN: 9800 Logan Ave S
LYNDALE: 9130 Lyndale Ave S
ISABEL: 71 Isabel St W
MIDTOWN: 2521 Bloomington Ave
11th: 3517 11th Ave S
ELLIOT: 2112 Elliot Ave S
26th: 1912 E. 26th S (ICS)
14th: 3223 14th Ave S
OAKLAND: 2636 Oakland Ave S
NEWPORT: 2300 Hastings Ave
ARCADE: 1047 Arcade St.
22nd: 3626 22nd Ave S
25th S: 3536 25th Ave S
26th: 19 E 26th St S.
25th N: 1108 25th
Other
OTHER PROGRAM EXPENSES
Intervention Services
Housing Stabilization Services
Grant Projects
Housing Navigation
Other
Information about purchase:
*
Please include amount, which client and/or unit number, reason, and any other important information related to the purchase.
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: