(SERR will reimburse you for any covered expenses noted above, providing you mark Reimburse = Y above and include receipts. Otherwise, we assume funds matching the expenses have already been removed from the race proceeds and TOTAL marked below.)
MONIES ENCLOSED
TOTAL
$
Details of Enclosed:
$TOTAL IN CHECKS
$
$TOTAL IN $50's
$
$TOTAL IN $20's
$
$TOTAL IN $10's
$
$TOTAL IN $5's
$
$TOTAL IN $1's
$
$TOTAL IN $COIN
$
$TOTAL IN OTHER
$
Was any race equipment in need of repair/replacement?
