ATLAS Invoice

NOTE: If you need reimbursement for Adult Diploma (ADP Working Group), ABE Managers, or Program Improvement 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*
MM slash DD slash YYYY
Your Name*
Please do not use all capital letters on this form - thank you!
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
Has the PAYEE ever been paid by ATLAS / Hamline University previously?*
If NO, then a Form W-9 must be submitted. Find instructions in the "Invoice & W-9 Instructions" box above.
- Yes
- No
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 (.585 for 2022) 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
* DO NOT UPLOAD YOUR W-9 here. Find instructions in the "Invoice & W-9 Instructions" box above. * A RECEIPT IS REQUIRED FOR EACH EXPENSE. Multiple receipts may be uploaded. Maximum file size is 100MB.
Drop files here or

Max. file size: 2 GB.
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!
Do you have any special instructions or comments regarding this invoice?
TOTAL PAYMENT*
(automatic calculation)
ELECTRONIC SIGNATURE: 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

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NOTE: If you need reimbursement for Adult Diploma (ADP Working Group), ABE Managers, or Program Improvement 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

Contact Us

Marisa Squadrito Geisler

Invoice & W-9 Instructions

Travel Date (mm/dd/yy)	Reason for Travel (e.g., North Regional)	From (city)	To (city)	Miles (ONE-WAY)	Mileage Rate (.585 for 2022)	AMOUNT

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

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