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Reimbursement Form

Fill out the form below completely. Receipts must be provided for all expenses. Either attach them here, or email to sue@ataxia.org. Accepted file types are: png, jpg, pdf, doc, docx, xls, xlsx, csv.

Reimbursements can be paid via ACH, check, or PayPal. ACH and PayPal are preferred, and will give you the fastest reimbursement. Checks are mailed through our BillPay service and will take 10-15 business days.

Any questions should be emailed to sue@ataxia.org.  Thank you!

Please note: Mileage is reimbursed per IRS standard: 67 cents/mile.

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