Expense Reimbursement Form

Pro Bono will reimburse volunteers for necessary out of pocket expenses. Please note that fax charges will not be reimbursed and any expenses in excess of $30.00 must have received prior approval from the Pro Bono Manager - esisti@603legalaid.org

Attorney's name

First Name

Last Name

Client's name

First Name

Last Name

Pro Bono Case number

1. Expense Type

Amount

2. Expense Type

Amount

3. Expense Type

Amount

Total Expenses Paid by Client

(litigation only)

Total Requested from Pro Bono