Reimbursement Request


  • The following information will prepare and guide you through the Reimbursement Request Submission and Process.
  • Once you have read through these instructions, you will be ready to start your Reimbursement Request by clicking on the Reimbursement Form Icon at the bottom of this page.


Access and Complete the first page of the form: 


  1. Your First and Last Name
  2. Last four of your Social Security Number
  3. Email Address
  4. Mailing Address
  5. Phone
  6. Text Phone
  7. Reason for Expense
  8. Expense Category, Date, Store Zip, Expense Amounts
  9. Digital image of the supporting documentation i.e. receipts
  10. The image should be accessible on the device used for submission

The image should be accessible on the device used for submission

Submit Receipts and Documents:

No Reimbursement will be processed without a digital copy of the supporting documents.      STEPS TO UPLOAD DOCUMENTS

  1. Click the gold shaded receipt area to begin upload
  2. Use Image Wizard Click    upload-arrow    to Browse for Images
    • (Optional Camera feature available to capture image)
  3. Find Digital Image and Select It, Then Click Open
  4. Image will appear in the wizard box
  5. Now Click on the Image you want to Insert –> it will be inserted
  6. Move to Next Receipt Upload Area and Repeat for Each Receipt or Document
  7. Confirm you completed the Form and UPLOADED THE CORRESPONDING Documents.
  8. Each section on the form will ask for the initials to verify the information is correct before proceeding.
  9. When you are finished, Click DONE in the TOP RIGHT Corner. done

Confirmation: How Will I know if My Reimbursement was submitted? 

  • First, a Congratulations page will confirm your request was submitted successfully.
  • Second, an email will also be sent to the email address that was provided. This email will contain a link for you to access a copy of your reimbursement submission.

Approval:  How will I know if my Submission is rejected?  

  • Your reimbursement request will be routed to accounting for approval.
  • On the condition that your submission is not approved, you will receive an email notification explaining the reasons for your denial.
  • If the problem is missing documentation, you will be allowed to edit your submission to upload proper documentation.
  • If your submission is rejected due to another circumstance, there will be an option to appeal the denial.

Getting paid:  When Can I Expect Payout on my Submission?

  • Most submissions are paid 3-5 business days after submission.
  • The accounting department must approve all reimbursement submissions.
  • If direct deposit is set up, you will see it directly into your direct deposit account.
  • All direct deposits will show as Reimburse Inc. on your bank statement.
  • Alternately, a paper check will be mailed to the address submitted on the form.
  • An email confirmation will notify you upon payout.

Help: Is there a Link that Provides Step by Step Instructions With Visual Aids?  

Reimbursement Request Form

1.  Click  rules-icon-sq icon  to access the Online Form.



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