Total number of charter members
Total
District Governor’s Signature
District
Date
Personal Auto Expense Worksheet
Date
Start
Odometer
Reading
End
Odometer
Reading
Total
km/mi
Traveled RI Rate* Subtotal
*See RI reimbursement rate sheets at www.rotary.org.
Total
Governors are reimbursed, separate from their allocation, for expenses related to the organization and chartering of a new
club. Actual and reasonable expenses will be reimbursed in the amount of one-half of the total charter fee for that club.
For example, if you charter a new club with 20 members, you may be reimbursed up to US$150.
RI does not reimburse the cost of framing the charter or of gifts for the new club (e.g., bell, banners, flag, podium) or its
charter members (e.g., lapel pins). You will not be reimbursed for expenses incurred by the sponsor club, the new club’s
charter members, spouses, the special representative, or other people involved with the organization of a new club and the
charter presentation.
Incidentals
Hotel and meals
Transportation (for automobile, enter total from
worksheet)
Expenses
Form J: District Governor Expense
Report for Organizing New Clubs
After the club charter presentation, please send this expense report form, along with your receipts, to your Club and
District Support representative. Receipts are required for any expense over US$75 and all hotel expenses. You may
find it easier to complete this report electronically and then print a copy to sign and submit.
Rotary Club of
District
Club admission date
Amount of charter fee paid
Currency used on this form
Charter presentation date
February 2008