ATLAS Invoice

Please 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.
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.
Name of PAYEE (who will receive the payment)*
If you are submitting an invoice on behalf of another person or organization, enter the name of the person/organization that is RECEIVING THE PAYMENT. If YOU are receiving the payment, enter your name.
Email of PAYEE (who will receive the payment)*
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
TRIP INFORMATION - ALL boxes are required
Travel Date (mm/dd/yy) Reason for Travel (e.g., North Regional) From (city) To (city) Miles (one-way) Mileage Rate (.545 for 2018 or .58 for 2019) AMOUNT
Total Mileage Reimbursement
(automatic calculation)
B) REIMBURSABLE EXPENSES - RECEIPTS REQUIRED (e.g., hotel, airfare, supplies, photocopies, etc.)
EXPENSE INFORMATION - ALL boxes are required
* NOTE: Meals are not usually reimbursable; please check first with ATLAS staff.
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 (e.g., presenter/facilitator fees, cohort participant stipends, study circle participant stipends, contract work, etc.)
PAYMENT INFORMATION - ALL boxes are required
Date(s) of Service or Activity Description/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.*
CAPTCHA

Travel Date (mm/dd/yy)	Reason for Travel (e.g., North Regional)	From (city)	To (city)	Miles (one-way)	Mileage Rate (.545 for 2018 or .58 for 2019)	AMOUNT

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

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

ATLAS Invoice

Please note: We cannot pay you unless you have a Form W-9 on file with Hamline.

PAYEE INFORMATION

A) MILEAGE REIMBURSEMENT

B) REIMBURSABLE EXPENSES - RECEIPTS REQUIRED (e.g., hotel, airfare, supplies, photocopies, etc.)

C) STIPENDS/CONTRACT PAYMENTS (e.g., presenter/facilitator fees, cohort participant stipends, study circle participant stipends, contract work, etc.)

BEFORE SUBMITTING INVOICE: Please check to make sure all required information is included.