To ensure prompt reimbursement please attach documentation of all expenses claimed, including mileage. You may submit your reimbursement requests online via the form below or you can download the FSBA Expense Form (PDF). All printed FSBA Expense Forms must be signed and supporting documentation emailed to Dunlap@fsba.org or mailed to:

Leslie Dunlap, 203 S. Monroe Street, Tallahassee, FL 32301.

FSBA Expense Form (PDF)

    Name:

    Your Email:

    Date of Trip or Expenses:

    Destination:

    Purpose of Trip or Expenses:

    EXPENSES

    Car Mileage:

    miles @ $.625 per mile =

    Airfare:

    Taxi:

    Tolls:

    Lodging:

    Meals:

    Car Storage:

    Tips:

    Other:

    Description of Other:

    Total Expenses:

    Less Advance (if any):

    AMOUNT DUE:

    Date Submitted:

    Attach Your Receipts: (PDF, Microsoft Word, Excel or JPG files only - file size limit: 2MB)

    Attach Your Receipts: (PDF, Microsoft Word, Excel or JPG files only - file size limit: 2MB)

    Attach Your Receipts: (PDF, Microsoft Word, Excel or JPG files only - file size limit: 2MB)


    captcha
    Type the code shown above.