Foster Care Expense Reimbursement Submission

Receipts entered today will be paid on Pay #2 next month. You may submit receipts for the current month and last month only. Retain receipts for 90 days in case additional information is needed.

Receipts must be legible and include store name, date of purchase, purchase total, and payment method. Capture more than one image, in sections, if needed to be legible.

Direct questions can be sent to fcpayme@buckeyeranch.org

Foster Parent Name Foster Parent Name First Last
Foster Parent Email
Date of Purchase Date of Purchase / MM / DD YYYY
Store Name / Business Name
Please upload a Photo of the receipt

Attach Files
Please select the number of kids you purchased items for on this receipt
Child 1 Name Child 1 Name First Last
Child 1 description of purchased item(s)
Child 1 amount spent $ Dollars . Cents
Child 2 Name Child 2 Name First Last
Child 2 description of purchased item(s)
Child 2 amount spent $ Dollars . Cents
Child 3 Name Child 3 Name First Last
Child 3 description of purchased item(s)
Child 3 amount spent $ Dollars . Cents
Child 4 Name Child 4 Name First Last
Child 4 description of purchased item(s)
Child 4 amount spent $ Dollars . Cents
Child 5 Name Child 5 Name First Last
Child 5 description of purchased item(s)
Child 5 amount spent $ Dollars . Cents
Child 6 Name Child 6 Name First Last
Child 6 Description of purchased item(s)
Child 6 amount spent $ Dollars . Cents