Payment/Reimbursement Request – First Congregational UCC Boulder

Contact Information

Julie Griffith, Office and Facilities Manager
Email: julie@firstcong.net
Phone: 303-442-1787 (ext. 0)

Check One:

Pay Attached Invoices
Reimbursement for Attached Receipts(s)
Payment Request (Attach Documentation if Available)

Payment to be Sent to the Following Payee:

Name:

Email:

Phone:

Address:

Address Line 1

Address Line 2

City

State

Zip Code

of your Church

Special Instructions:

NOTE: Payment will be sent to payee unless you have special instructions.

Payment/Reimbursement Method (please select one):

Electronic, direct to my bank account
Check in the mail

First Cong uses Bill.com, a national secure bill processing system, for payments. We prefer to send payments electronically:

Electronic payments are free; we pay a small fee for every check we process.
Checks are sent from Bill.com's processing center in a plain windowed envelope. Recipients occasionally throw the envelope out thinking it's junk mail. We then have to void and reissue the check, costing us extra work and a $25 fee.

If you choose electronic payment, you will receive an email with a link to set up your payment with your bank information; the data is stored in Bill.com's bank-grade secure system, and is not seen by First Cong.

Church Account To Reimburse From (e.g. Board of Spiritual Life):

This section is to include the church account name and internal number where the reimbursement or payment should be recorded.

Account Name(s):

Account Number:

$ Amount

Purpose

Account Name:

Account Number

$ Amount

Purpose

Account Name:

Account Number

$ Amount

Purpose

Upload Documentation:

Only file types allowed include .pdf, .png, and .jpg.

Click or drag files to this area to upload. You can upload up to 3 files.

By typing your name below you are attesting to the accuracy of this information.

Requestor Signature (type your name below):

Date:

Procedure For Requesting Expense Payment/ Reimbursement:

The REQUESTER should complete this form as fully as possible, attaching invoice(s)/ receipt(s) and verifying that the invoices/receipts match the amount requested to be paid. Please request within 30 days.
Don’t mix reimbursable and personal charges on a receipt. Please purchase reimbursable items separately.
Please become familiar with the account(s) from which you may be making requests for expense payments or reimbursements, so the form is fully completed with the Account Name and Number.
Please submit at least one week in advance of when payment is to be processed.