Reimbursement Form
Reimbursement Request Form
Request reimbursement for approved District 5330 expenses.
Get started
District officers, committee chairs and event chairs can request reimbursement for approved District expenses. Download the form below, complete it, attach copies of your receipts or invoices, and send it to the District Treasurer.
Download the Reimbursement Request Form (PDF, 130 KB)
The form is a print-and-complete PDF — it has no fillable fields, so print it or fill it in using your PDF reader’s text tool before signing.
Completing the form
- Member information. Your name, email, phone, club name and the date. Payment goes to the person named as the requestor.
- Event chair signature. The event chair signs and dates the form.
- Expense details. Itemize each expense by date, description and amount, and attach copies of receipts or invoices.
- Event affiliation. Tick at least one — District Assembly, District Conference, Paul Harris Foundation Dinner, RYLA, Pre-PETS, PETS, PRYDE, RLI, IGNITE, Human Trafficking, Music Competition, Speech Competition, or Other.
- Payment method. Tick Bill.com if you’d like to be paid directly to your bank account (see below).
Reimbursements must fall within the approved District budget.
Bill.com — the preferred method
Bill.com is the District’s preferred method for reimbursements — fast, secure and hassle-free. Sign up to receive payments directly to your bank account, eliminating checks and paperwork: quick deposits, encrypted protection and full online control anytime.
To opt in, tick the Bill.com box on the form. You’ll then receive a secure link by email from Bill.com — click it and complete your account setup.
Submit to the District Treasurer
Mail, fax or email your completed request to the District Treasurer.
Allyson J Trantum, CFP
District Treasurer
27710 Jefferson Ave, Suite 104
Temecula, CA 92590
Phone & fax
Phone: (951) 440-7917
Fax: (951) 473-2234
You can also reach the Treasurer through the District Leadership page.