MODR Leader Mileage Reimbursement Form

Please Note

Reimbursement from Missouri Baptist Disaster Relief (MODR) depends upon certain criteria which is indicated in the form. In each case, reimbursement will only occur if the following conditions are met:

The reimbursement request is made within 30 days of deployment.
The bugeted funding for reimbursements has not been depleted.
The reimbursement request is made with the appropriate MODR mileage reimbursement form and option.

If these conditions are not met, we will not be able to process a reimbursement..

For questions on how this policy affects your taxes, please consult your tax advisor.

DR Leader Mileage Reimbursment Form

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

I am requesting a mileage reimbursement because:(Required)

I am a part of the MODR training staff who attended a training.

I am a part of the MODR leadership who attended a MODR meeting.

Please Note:

MODR agrees to reimburse Training Staff for travel related to participation in training events. This is done at the current IRS Charitable Rate ($.14/mile).

Please Note:

MODR agrees to reimburse MODR Leaders for travel related to participation in MODR meetings. This is done at the current IRS Charitable Rate ($.14/mile).

Phone(Required)

For which event do you need a mileage reimbursment?(Required)

When did this travel begin?(Required)

For how many total miles do you need a reimbursement?(Required)