Request Reimbursement

Submit a cover letter and an itemized sheet with your receipts to get reimbursed by the fund for qualified charitable expenses. Please provide as much information and detail as you can and Legacy will process your request.

Task Title *

Fund Name *

Recipient Name *

Your Email *

Recipient Phone

Recipient Address *

Expense Date *

Reimbursement Amount *

Payment Method *

Reimbursement Description *

Reimbursement Details *

Please upload a PDF itemizing and detailing what these funds were used for and how it qualified for reimbursement.

Receipts *

Please upload all receipts for this reimbursement here.

Tax ID Document

We need a Tax Identification Document on file for every legal recipient being paid. This document must be updated annually before payment.
Please Upload One Of The Following Documents As Applicable:
1. W-9 = For All US Domestic Persons Or Entities
2. W-8BEN = For All Non-US Foreign Persons
3. W-8BEN-E = For All Non-US Foreign Entities

Thank You For Your Request