Please use this form  for reimbursement of expenses or for payments to third parties (download or print and then fill out):

Attach receipts -Tax should not be included - Girl Scout expenses are tax exempt except Council purchases. Please use your tax exempt number whenever possible.  Include details such as:

• number of girls/adults paid
• number of girls/adults who actually participated
• amount collected
• amount spent
• itemized list of purchases, etc.

  ___Please Mail

  Address (if different from above:) ___________________________

  ___Pick Up (please call first)
  ___Put in Leader's File

Records are kept for each Girl Scout activity. Give as much information as possible.

MAKE CHECK PAYABLE TO: (please print clearly)

Name _______________________________________

Address _____________________________________

Phone ______________  Email ___________________

Please indicate if check should be mailed, will be picked up at Treasurer's home, or should be left in Leaders file for pick up at the next Leaders Meeting.

Details for Reimbursement: Indicate below or attach explanation:

Date	Girl Scout Activity	Other Details	Receipt Attached?	Amount of Reimbursement

Check Total: (Exclude Sales Tax or Explain) $______________

Please affix receipts to back of voucher and submit to Treasurer, Scarsdale/Edgemont Girl Scouts: Mary M. Ellis, 46 Graham Road, Scarsdale,NY 10583