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  • PFS LE Request for Reimbursement Form

    All funds requested MUST be presented on this form. All forms MUST be submitted electronically; no hand writing will be accepted.
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  • Reporting period for date of service:

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  • Expense #1

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #2

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #3

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #4

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #5

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #6

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #7

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #8

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #9

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • Expense #10

    You must enter each expense individually. To add additional expenses, select "yes" when asked if you have another expense to request for reimbursement below. All expenses should mirror the contents of your submitted budget. At the end, you will need to upload all receipts or proof of purchases.

  • If you have additional expenses to request for reimbursement, please submit a second form. 

    Complete the Law Enforcement Reimbursement Calculation Form found here.  Attach the document to this request along with any receipts for supplies, equipment, or contract purchases. Sign and select submit. 

     

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  • By sending in this form, you certify that the amount detailed represents expenditures of funds for the period covered and for the total project, all made in accordance with the approved budget for the above-named project. You also certify that no grant funds have been used to supplant or lobby.

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