ONA Local Expense Reimbursement

Thanks for submitting an expense report for a pre-approved expense reimbursement from the ONA Local budget. This form is for expenses that have been approved by ONA staff.

It usually takes a few weeks for us to process the reimbursement. If you have any questions in the meantime or need to make a correction, please email local@journalists.org.

You can submit up to eight receipts at a time using this form. If you have more than eight to submit, contact local@journalists.org for a spreadsheet version of the expense report.

Photos or scans of receipts must be attached for reimbursement. Please make sure to include itemized receipts that show what was purchased — not just the credit card copy or total amount — and ensure the photos are readable.

First Name *

Last Name *

Do you live: *

Inside the United States

Outside the United States

Phone Number *

Email Address *

Which ONA Local group hosted the event? *

For U.S. residents: We will issue a check mailed to the address you provide below. Please double check the spelling and make sure it's a place you can receive mail.

Street Address *

Address Line 2

City *

State *

Zip Code *

For non-U.S. requests, we will reimburse you using Paypal. Please give us the username or email associated with your Paypal account: *

Receipt #1

Category *

Date expense was incurred * +

Amount of expense (in USD) *

Explanation of Expense *

Photo or Scan of Itemized Receipt

Receipt #2

(if applicable)

Category

Date expense was incurred +

Amount of expense (in USD)

Explanation of Expense

Photo or Scan of Itemized Receipt

Receipt #3

(if applicable)

Category

Date expense was incurred +

Amount of expense (in USD)

Explanation of Expense

Photo or Scan of Itemized Receipt

I have more expenses to submit today

Yes

No

Receipt #4

(if applicable)

Category

Date expense was incurred +

Amount of expense (in USD)

Explanation of Expense

Photo or Scan of Itemized Receipt

Receipt #5

(if applicable)

Category

Date expense was incurred +

Amount of expense (in USD)

Explanation of Expense

Photo or Scan of Itemized Receipt

Receipt #6

(if applicable)

Category

Date expense was incurred +

Amount of expense (in USD)

Explanation of Expense

Photo or Scan of Itemized Receipt

I have been approved to be reimbursed for mileage

Yes

No

Mileage

(if applicable)

Number of miles driven - Please enter numbers only; round to the nearest whole number; no punctuation

Mileage reimbursement at 2022 IRS rate of 58.5 cents/mile - enter miles driven above and then press Calculate to see rate of reimbursement

0.00

Once you've entered the expense amounts in USD above, press "Calculate" to update the total.

Current Total:

0.00

Take a look: Does the total look right?

Please double check the amounts of the receipts and the total — if they aren't what is shown in the images you've uploaded, we'll have to send it back to you. (About 1 in every 4 expense reports we get has a math error, so it's worth taking a moment to look at it again — it'll save everyone time and help us get your reimbursement to you faster!)

I HEREBY CERTIFY THAT THE ABOVE EXPENDITURES REPRESENT CASH SPENT FOR ONA BUSINESS ONLY. Please sign below with your cursor. *

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