MONTEBELLO UNIFIED SCHOOL DISTRICT
INSTRUCTIONAL SUPPLIES REIMBURSEMENT FORM
Please Issue Check To
(Please Print)
School (Location)
“I hereby certify that the item(s) purchased is/are for instructional use and the requested
reimbursement amount is accurate and correct.”
$
(Signature) (Date) (Amount)
Bargaining Unit members may begin utilizing the 2020-2021 $200 instructional supply reimbursement in the
2019-2020 school year. (Article XII.3 Wages p. 20)
Bargaining Unit members will complete the District Reimbursement Form for consumable instructional
supplies purchased.
Bargaining Unit members will complete the District Reimbursement Form including the Asset Tracking
Section for equipment purchased. Any equipment reimbursed by the District is property of the District, and
joint ownership does not apply.
The total reimbursement for supplies and/or equipment will not exceed the $200.
The District Reimbursement Form must be sent (e.g., U.S.P.S. or electronically) including all receipts to
Finance at the District office for payment and proper asset tracking. The reimbursement form is available
on the District website on the Finance page. Reimbursement forms may be turned in until January 31, 2021.
The reimbursement will be processed in a timely manner. Finance@Montebello.k12.ca.us or MUSD Finance
123 S. Montebello Blvd. Montebello, CA 90640
1. Print your full name, school (location), sign and date, and enter reimbursement amount
2. Attach original receipt(s)
3. Submit to District Office Finance department for reimbursement
