Speaker Reimbursement Form | Maryland Association of CPAs (MACPA)

Name
First Last
Firm / Organization Name*
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
MACPA Conference Name
Date of Conference / Presentation Date*
Date Format: MM slash DD slash YYYY
Travel
- Car
- Plane
- Other
Mileage
This amount will be reimbursed at the current IRS rate.
Hotel accommodations
Meals
Other expenses incurred - please specify
Total reimbursement
Please attach all receipts
Drop files here or
Check payable to firm or individual?
- Firm
- Individual
If a check is requested, should it be made payable to the firm or individual
Confirm payee information below:
IN ORDER TO RECONCILE ALL COURSE ACCOUNTS, WE RESPECTFULLY REQUEST THAT THIS REIMBURSEMENT FORM BE SUBMITTED TO THE MACPA NO LATER THAN TWO WEEKS AFTER THE PROGRAM. IF THE MACPA DOES NOT RECEIVE A REQUEST FOR REIMBURSEMENT IN THAT TIME, WE WILL ASSUME THAT NO EXPENSES WERE INCURRED.
E-signature/agreement*
E-signature/agreement
By checking this box, I confirm the details of this submission.

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