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INVIAN RIVER COUNTY <br />CH'LOREN'S SERVICES ADVISORY COMMITTE <br />REIMBURSEMENT REQUEST - FY25 26 <br />Agency Program <br />AdJiess Phone <br />Email =ax <br />REQUEST O <br />'Expenses must In:tude derrnted original invoice and receipt or rdr celed Check as pawl of paymem. <br />'Satar*S must shCw a tneakdown the hours pard by type f e.g., tegular, s+ -.k. varalwml. Please mote the Cau,.,ty will N01 Rttnibwse fu, SICK o: VACATION <br />lir'* so those must bededucted from trio t€quest �rtol to submitluN <br />'Remove sick, PTO <br />^.dtot Holidays ne t <br />recognized by ON <br />Tax Empbay#r <br />contribi*io ► <br />Retirement Employes <br />Contribution <br />r1p14y's contributie- <br />reflected in gr oss <br />Total <br />Catculatei! <br />�t`ffeT4td�,F <br />F3f Total tcs 6e <br />Requested <br />Total Ft+:>gs#�,s'iHrS <br />l0G% <br />S <br />loam <br />S <br />a <br />iWIL <br />S <br />S <br />;oovc <br />$ <br />S <br />10011i: <br />S <br />S <br />s <br />s <br />s <br />s <br />s <br />S <br />[r <br />J <br />S <br />S <br />� <br />S <br />3 <br />S <br />'Expenses must In:tude derrnted original invoice and receipt or rdr celed Check as pawl of paymem. <br />'Satar*S must shCw a tneakdown the hours pard by type f e.g., tegular, s+ -.k. varalwml. Please mote the Cau,.,ty will N01 Rttnibwse fu, SICK o: VACATION <br />lir'* so those must bededucted from trio t€quest �rtol to submitluN <br />