Columbia Heights Mutual Aid - Expenses and Reimbursement

Columbia Heights

Mutual Aid

Expense Form

Record your expenses for the Columbia Heights Mutual Aid network and request reimbursement. We track reimbursements carefully to ensure transparency, accountability, and sustainability of our Mutual Aid funds.

Important

You may only be reimbursed for:
- Aid items that were requested by community members
- AND approved by Mutual Aid organizers.
We may contact you for clarification before processing a reimbursement request.
Feel free to contact a Mutual Aid organizer if you have any questions about your expenses or reimbursements.

Please complete this form as soon as possible after your purchase.

Your Name *

First

Last

Email *

Phone

Best way to contact you *

Email
Text Message
Phone call

Total Expenses *

Sum of all receipts in $ USD

Receipts *

Drag & Drop Files, Choose Files to Upload You can upload up to 20 files.

For the best receipt images, we recommend the ‘Clear Scan – PDF Scanner App’ available via Google Play and the App Store.

Expense Types *

Food / groceries
Medication / pharmacy
Gas / transportation
Laundry
Rent / housing
Clothing
Hygiene / personal supplies
Baby supplies
Pet supplies
Cleaning / household supplies
Other

Are you requesting reimbursement? *

No. Please record this expense as my donation.
Yes. Please reimburse me for this expense.

Address Name do

Reimbursement method

Venmo
Check

Apologies, we are experiencing technical difficulties with Venmo at this time.

Venmo Username *

In your Venmo profile, your username (starting with an “@”) is displayed right below your name.

Check Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

How do you want to receive your check?

Mail
Pickup at Railwerks

All checks will be mailed. Pickup at Railwerks is no longer an option.

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