ATLAS Invoice

NOTE: If you need reimbursement for Adult Diploma (ADP Working Group), ABE Managers, Program Improvement, or Statewide PD Committee meetings/activities, or the ABE Summer Institute, please go to the Literacy Action Network website.

Submitter Information
This is the person submitting the invoice - which may be the same or different from the PAYEE.
Date of Submission*
Date Format: MM slash DD slash YYYY
Your Name*
First Last
Your Email*
Enter Email Confirm Email
Your Phone*
Payee Information
The PAYEE is the individual or organization to whom the check will be written. NOTE: We cannot pay you unless you have a Form W-9 on file with Hamline. Please see https://atlasabe.org/submit-invoice/ for information and instructions.
Are you submitting this invoice on behalf of another person or organization that should receive the payment?*
- Yes
- No; I am the payee and should receive this payment.
Name of PAYEE (who will receive the payment)*
Email of PAYEE (who will receive the payment) or payee's representative*
Enter Email Confirm Email
Address of PAYEE (who will receive the payment)*
Street Address Address Line 2 City State ZIP Code
Is this a new/updated address for this PAYEE?*
- Yes
- No
- Unsure
Is the PAYEE an employee of Hamline University?*
- No, the payee is not employed by Hamline
- Yes, the payee is Hamline staff
- Yes, the payee is Hamline regular faculty
- Yes, the payee is Hamline adjunct faculty
A) Mileage Reimbursement
Fill out if applicable. NOTE: Mileage only reimbursed for trips of 50 miles or more one-way.
TRIP INFORMATION - ALL boxes are required
(Click PLUS SIGN to enter your RETURN TRIP; be sure to claim BOTH one-way trips!)
Travel Date (mm/dd/yy) Reason for Travel (e.g., North Regional) From (city) To (city) Miles (ONE-WAY) Mileage Rate (.575 for 2020 / .58 for 2019) AMOUNT
Total Mileage Reimbursement
(automatic calculation)
B) Reimbursable Expenses (receipts required)
Fill out if applicable. Examples include hotel, airfare, supplies, photocopies, etc. NOTE: Meals are usually NOT reimbursable; please check first with ATLAS staff.
EXPENSE INFORMATION - ALL boxes are required
(Click PLUS SIGN to add more rows)
Date(s) of Expense Description/Reason for Expense Amount $
UPLOAD RECEIPTS
* A RECEIPT IS REQUIRED FOR EACH EXPENSE. Multiple receipts may be uploaded. Maximum file size is 100MB.
Drop files here or
Total Expense Reimbursement
(automatic calculation)
C) Stipends / Contract Payments
Fill out if applicable. Examples include presenter/facilitator fees, cohort participant stipends, study circle participant stipends, contract work, etc.
PAYMENT INFORMATION - ALL boxes are required
(Click PLUS SIGN to add more rows)
DATE(s) of Service / Activity Description of Activity / Reason for Payment Amount $
Total Stipend/Contract Payments
(automatic calculation)
Before Submitting Invoice
Please check to make sure all required information is included. Thank you!
TOTAL PAYMENT*
(automatic calculation)
ELECTRONIC SIGNAURE: By typing my initials below, I certify that all information submitted herein is accurate and truthful.*
MILEAGE REMINDER: Did you claim BOTH one-way trips? (instructions are above)
CAPTCHA

Travel Date (mm/dd/yy)	Reason for Travel (e.g., North Regional)	From (city)	To (city)	Miles (ONE-WAY)	Mileage Rate (.575 for 2020 / .58 for 2019)	AMOUNT

Date(s) of Expense	Description/Reason for Expense	Amount $

DATE(s) of Service / Activity	Description of Activity / Reason for Payment	Amount $

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ATLAS Invoice

NOTE: If you need reimbursement for Adult Diploma (ADP Working Group), ABE Managers, Program Improvement, or Statewide PD Committee meetings/activities, or the ABE Summer Institute, please go to the Literacy Action Network website.

Submitter Information

Payee Information

A) Mileage Reimbursement

B) Reimbursable Expenses (receipts required)

C) Stipends / Contract Payments

Before Submitting Invoice