DISBURSEMENT REQUEST FORM Account Number: WTC 2026

1. Click ‘Get Form’ to open the DISBURSEMENT REQUEST FORM in the editor.
2. Begin by entering the Beneficiary Name and Date at the top of the form. Ensure that these details are accurate as they are crucial for processing your request.
3. In the section labeled 'Date of Receipt/Invoice', input the date corresponding to each receipt or invoice you are submitting. This helps in tracking your expenses.
4. Fill in the 'Vendor/Provider/Place of Purchase' field with the name of the vendor or service provider from whom you made purchases.
5. Detail each item or service purchased in the 'Item(s)/Service(s) Purchased' section. Be specific to avoid any confusion during processing.
6. Enter the total amount from your receipts or invoices in the 'Receipt/Invoice Total' field, followed by filling out 'Total Amount Requested'.
7. Indicate if all receipts/invoices/bills are itemized and complete, ensuring they are attached without any writing on them.
8. Complete your contact information and relationship to beneficiary, selecting from options provided.
9. Finally, sign and date the form before submitting it via email, fax, or mail as indicated at the bottom of the form.

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