Submit Your Receipts or Invoice

UMVA Expense Reimbursement Form (updated)

For project leaders, exhibition organizers, and other UMVA members who incur UMVA-approved expenses. Vendors who have provided a service for UMVA may also submit their invoices here.

Date(Required)

Date of your request (not of your event or project)

Your Contact Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone

Direct Deposit Information (optional)

Routing Number

If you prefer direct deposit vs. check

Checking Account

If you prefer direct deposit vs. check

Details About Your Request

UMVA Project(Required)

ARRT!

LumenARRT!

Maine Arts Journal

Maine Art in America

Maine Masters

UMVA Exhibition

Other

Name of Your Event, Exhibition, Article, Film, etc.(Required)

Request Type (select only one)(Required)

Reimbursement/stipend

Contractor/vendor invoice

Please note: Upload RECEIPTS for reimbursement or INVOICES for contractor/vendor payment. Expense requests under $1000 will be reviewed by the project manager, editor, or exhibition producer. Expenses over $1000 require the approval of the UMVA Board of Directors. If you have any questions about allowable expenses for your project, please check in before incurring costs.

Upload Receipts or Invoices

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 3 MB.

Please provide your receipts or invoices as .pdf, .jpg or .png. Maximum file size: 3MB. You may include multiple files/images as your documentation.

Itemize Your Expenses

You may enter up to 15 expenses. (Form will expand as you fill in amounts.) DO NOT combine multiple expenses or amounts.

Expense examples: Wall text. Reception refreshments. Postcard printing. Bob Smith, stipend.

Expense 1(Required)

List each expense/individual separately.

Amount 1(Required)

Enter dollar amount, including decimal. Do not include dollar sign. ($ is automatically added). Example: 114.72

Expense 2

Amount 2

Expense 3

Amount 3

Expense 4

Amount 4

Expense 5

Amount 5

Expense 6

Amount 6

Expense 7

Amount 7

Expense 8

Amount 8

Expense 9

Amount 9

Expense 10

Amount 10

Expense 11

Amount 11

Expense 12

Amount 12

Expense 13

Amount 13

Expense 14

Amount 14

Expense 15

Amount 15

TOTAL AMOUNT REQUESTED(Required)

The total amount should equal the sum of your itemized lines above. Enter the dollar amount including decimal. Do not include dollar sign. ($ is automatically added.)

Additional Information

Use this space to provide any additional notes or explanations (not in the Name of Your Event, Etc. field). If you have more than 15 expenses, please do not add them here—use a second form.