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Expense Form
MPFFU Expense Account Form
Note: Please submit a different form for each activity. 

Make sure you include the date, location and description of the event or your activity.   Please submit the form ASAP, but no later than 14 days after the meeting takes place.

For mileage reimbursement, just enter the number of round trip miles. The payroll program will calculate the amount. The rate is $0.67 per mile. Please contact the MPFFU office if you have any questions.  

Please cash or deposit your check within 5 days of receiving it.

PLEASE INCLUDE YOUR NEW MAILING ADDRESS IF YOU RECENTLY MOVED.  The check addresses are not linked to our membership database.

Full name:
Title or Committee:
Email Address:
Date(s) of Activity
Authorized by ? (Sahr, Chesney, or Committee Chairperson)
For DVP's:  Describe the issue(s) that were addressed on each date
Number of Days at $110
Number of Days at $266
Total Round Trip miles (Enter number of miles)
Additional Reimbursement Amounts (Explain Below)
ACTIVITY DETAILS:  Itemize any reimbursement amounts or indicate if you recently moved since your last payment.
Enter the text shown in the image above.

1651 Kingsway Ct., Suite E
Trenton, MI 48183

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