Payment Voucher – Lifepoint

Payment Voucher

Name *

Attach Receipts

File Upload

Maximum upload size: 14MB

Note: This form will not accept HEIF photos, which is the default for newer iOS photos. See these solutions: How to convert an HEIF file to jpeg | How to change iOS Photo Default to JPEG

Expense 1

Amount *

Account *

Explanation *

Expense 2

Amount

Account

Explanation

Expense 3

Amount

Account

Explanation

Expense 4

Amount

Account

Explanation

Expense 5

Amount

Account

Explanation

Summary

Make check payable to

Payment Instructions

Sending