NOTE: Each receipt must be submitted separately.
* indicates required fields.
1. Name of Purchaser *
2. Purchase Date *
3. Purchase Amount *
4. Merchant Name *
5. Business Purpose *
6. Participants (if food-related) *
9. Please provide employee ID number *
10. STAP Fund Balance (please verify balance in Axess)
11. Amount of STAP Funds to be applied *
12. Upload Receipt ( 1 receipt per request) *
13. PTA ______________________Expenditure Type____________
14. Email address *
Please skip. Do not fill this out.