National Charity League Inc.

Riverside Chapter

Payment Voucher

Date: ________________________________________

Make check payable to: ___________________________________________________________________

Address: _______________________________________________________________________________

For: ______________________________________________________________________________________

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Requested by: ______________________________________________ Phone: _____________________

Committee: _____________________________________________________________________________

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Amount Requested: $ _____________________________

Attached all bills, invoices and/or receipts to this voucher and submit to National Charity League Inc. Riverside’s Chapter Treasure for payment. This form must be completed for payment.

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For Treasurer’s use only:

Date: _________________________________ Check Number: ___________________________

Amount: ______________________________ Check Canceled: __________________________