Follow Rules and Explanations on Back, Please

REIMBURSEMENT FORM (Submit by mail or attached, legible pdf to Committee/Team Leader or Budget Manager.)


Committee/Team & Project Names ______

Reason for Reimbursement & Dates of Expenditures ______

Please include original receipts for all expenses over $25 and itemize them individually.
6110 Printing / 6310 Ground Transportation
6140 Supplies / 6310 Mileage (list departure/arrival destinations)
6150 Postage / ______miles x $0.25 =
6190 Phone/Fax / 6310 Parking
6310 Lodging / Other (explain)
6312 Meeting / Itemized Total
(minimum $25) $ ______

DIRECTORS ONLY -Directors- Grand Total

6340 Per Diem (max. $30/day) ______(Itemized plus per diem): ______


Reimbursement requested by Approved by Leader/Budget Manager

Print name______Signature______Date ___


Address______Dept. ID (three digits) _ _ _

______Product Code, use only one code per form:

Phone ______Admin & Indirect lobbying B B _ _ _ _

Email ______Charitable/Educational C C _ _ _ _

Direct Lobbying D L _ _ _ _

Bill #, Position ______

Committee/Team Leader or Budget Manager Sends Form (electronic submissions preferred) To:

BOD/Board Committees/CCL Grassroots Network Campaigns & Programs Chapter & Leader Support

Dassance Raymond Gwyn Jones YuYu Thein Scott Elkins

Sierra Club Sierra Club Sierra Club Sierra Club

85 2nd St., 2nd Fl 50 F St. NW, Suite 800 85 2nd St., 2nd Fl 2327 E. Franklin Ave, Suite 1

San Francisco, CA 94105-3441 Washington, DC 20001 San Francisco, CA 94105-3441 Minneapolis, MN 55406

Sierra Club National Signature______Date ______

General Reimbursement Rules December 2014

A. To reduce paperwork generated from small reimbursements, the minimum reimbursement request is now $25. Less than $25 is allowed for an annual reimbursement. Reimbursement requests should be submitted monthly or as soon as they exceed $25.

B. Fixed assets (i.e., depreciable items such as: computers, cell phones, cameras, etc.) are not reimbursable.

C. The Sierra Club’s Assistant Treasurer must approve any exceptions to reimbursement rules in advance.

D. The reimbursement form must be properly coded, signed by two people (requester and committee/team chair or treasurer), completed in all relevant sections, and accompanied by receipts for any expense greater than $25.

E. Reimbursement checks will generally be issued within 10 working days of receipt at the national office if these rules are followed and forms are properly completed.

Rules and Explanations for specific items on form

Receipts for all items >$25 are required by the IRS. Reimbursement will not be made without required receipts.

6190 Phone/Fax: Attach copy of bills with SC calls highlighted. Maximum cell phone reimbursement $40/mo.

6310 Lodging: Hotel reservations must be made at least 30 days in advance through the Club’s travel agent (Travel Leaders at (888) 963-7230 or use Concur online at The President (for the Board and its committees) or the Assistant Treasurer (for others) must approve any exceptions in advance. Volunteers must share hotel rooms or personally pay the difference for a single room, unless there is not another person of the same sex with whom to share. Committee/team chairs may grant exceptions to room sharing requirements for unavoidable difficulties or unusual circumstances. All exceptions must be requested and approved in advance. Lodging is reimbursable for travel and meeting days only. In-hotel services are not reimbursable.

6310 Ground Transportation: If public transportation (first choice) or airport shuttles (second choice) are available, taxi rides to and from an airport are reimbursable only up to the shuttle rate.

6310 Mileage: $.25/mile, up to the lowest cost airfare per trip, cumulative maximum 4,500 miles/year per volunteer.

Other: List and explain any other expense that does not fit into a listed category. Use a separate sheet if necessary.

Food expenses are not reimbursable. Very infrequently, committee/team chairs may grant per diem up to $15 per day (meeting days only) out of their committee/team budget for needy volunteers. Routine per diem for committee/team members will not be reimbursed. At their discretion, committees/teams may provide working breakfasts and lunches, and may host an annual volunteer appreciation dinner for their members (limit $35/person). The above applies to Activist Network teams only if it is an integrated part of an approved project.

Air transportation is not reimbursable. All travel arrangements (air, train, car rental) must be made at least 30 days in advance through the Club’s travel agent (Travel Leaders) and will be directly charged to the appropriate committee/team. Exceptions may be granted in rare circumstances, but only with advance approval of the committee/team chair and the national Club Assistant Treasurer – code to 6311.

Only Directors may request an optional per diem reimbursement up to $30/day for meeting days, in addition to the normal reimbursable expenses of hotel and local transportation.

Every reimbursement request (except for Directors) must be signed by a second person, either the treasurer or the chair of the committee/team, or the chair of the next higher committee (Support Team for Activist Network teams). The signature of a chair or treasurer signifies that they have checked the form for accuracy and completion of all requirements, including receipts, mathematical accuracy, and proper coding. If a form lacks any information or approval by the second signatory, the form will be returned for proper completion.

Department ID identifies entity to be charged. Directors assigned to committees charge related expenses to the committee. Non-Director volunteers asked to attend Board meetings charge expenses to their committee/team (may charge to the Board budget only with advance approval of the President or her/his designee).

Product Code has 6 characters (2 letters, then 4 numbers), and identifies direct lobbying, c3, or c4 funding source. This is required for all conservation expenses, including Activist Network teams. Use one code per form.

Payments to businesses (i.e., mailing house, printer) or individuals (i.e,, designer, researcher, attorney) for services:

Direct payments may be made to a business if an approved invoice is provided. An IRS Form W9 from the business must be on file. If this business is being paid for the first time, please obtain and attach a completed W9 ( For more information or help, contact .

BEFORE an individual is engaged for services (such as design work, consulting, etc), you must contact the Human Resources Department () to determine whether an Independent Contractor agreement is required. A taxpayer ID must be provided for all payments to individuals for service. All submitted invoices must itemize materials and labor charges separately.