Theresa, NY · Jefferson County
Voucher/Purchase Claim Form
This voucher lets a claimant request payment from the Town of Theresa for materials or services provided to the municipality.
What this form is
Use this form to claim an amount due for materials, services, or disbursements provided to the municipality. It asks for claimant and purchase details, itemized amounts, and a signed certification that the claim is true, unpaid, and actually due. Detailed invoices may be attached, with their total entered on the voucher.
Who needs it
A claimant seeking payment for materials, services, or disbursements provided to the Town of Theresa can complete this voucher.
How to submit it
Submit the completed voucher to the Theresa Town Office, 215 Riverside Ave., Theresa, NY 13691. The form does not list an email address, portal, or fee.
About notarization
This document is signed and dated without a notary; it asks the claimant to certify the claim, and no notarized attachment or related step is listed.
How to submit this form
- 1
Download The Voucher
Download the Voucher/Purchase Claim Form.
- 2
Complete The Claim
Enter claimant and purchase details, including materials or services, quantities, prices, and amounts.
- 3
Gather Invoices
Attach detailed invoices if applicable and enter their total on the voucher.
- 4
Sign And Submit
Sign and date the claimant certification, then submit the voucher to the Theresa Town Office at 215 Riverside Ave.
Frequently asked questions
- What is the Theresa Voucher/Purchase Claim Form for?
- It is used to claim an amount due for materials, services, or disbursements provided to the municipality. It includes purchase details and a claimant certification.
- Do I need a notary for the Voucher/Purchase Claim Form?
- No. The claimant signs and dates the certification without a notary. The form does not list a notarized attachment or related step.
- How do I submit the Voucher/Purchase Claim Form?
- Submit the completed form to the Theresa Town Office at 215 Riverside Ave., Theresa, NY 13691. The form does not provide an email address or online submission portal.