EXPENSES CLAIM FORM (EXP1)
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1 EXPENSES CLAIM FORM (EXP1) Incurred by: PRINT NAME claim Internal or external address If you are not an employee, please can you detail your relationship to the University? Payment details (Only required if not a member of staff) UK Bank Sort Code: UK Bank Account No: Travel costs Purpose of journey From To Miles Rate Accommodation and other travel related costs Reason for Total mileage 0 (a) Details of Other expenses Details of expenses (b) Coding (c) Account Cost Centre Job/Project DA SC TC Section totals (a+b+c) Grand total Declaration I declare that the expenses claimed are in accordance with the approved scales of payment as set out in the University's Financial policies and procedures and that no other claim has been or will be made for this from the University or any other organisation. The claim for subsistence is not in excess of the actual costs incurred. Certification I certify that the expenses claimed were necessarily incurred on University business and comply with the University's Financial policies and procedures. Where receipts are required under the University's Financial policies and procedures I confirm that the original copies are attached, have been checked and are legitimate. Claimant: SIGNATURE Where paid in cash: SIGNATURE Authorised by: PRINT NAME Authorised by: SIGNATURE
2 EXPENSES CLAIM FORM (EXP1) Incurred by: PRINT NAME claim Internal or external address If you are not an employee, please can you detail your relationship to the University? Payment details (Only required if not a member of staff) UK Bank Sort Code: UK Bank Account No: Travel costs Purpose of journey From To Miles Rate Accommodation and other travel related costs Reason for Total mileage 0 (a) Details of Accommodation and other travel related costs sub total c/f
3 Accommodation and other travel related costs sub total b/f Other expenses Details of expenses (b) Coding (c) Account Cost Centre Job/Project DA SC TC Section totals (a+b+c) Grand total Declaration I declare that the expenses claimed are in accordance with the approved scales of payment as set out in the University's Financial policies and procedures and that no other claim has been or will be made for this from the University or any other organisation. The claim for subsistence is not in excess of the actual costs incurred. Certification I certify that the expenses claimed were necessarily incurred on University business and comply with the University's Financial policies and procedures. Where receipts are required under the University's Financial policies and procedures I confirm that the original copies are attached, have been checked and are legitimate. Claimant: SIGNATURE Where paid in cash: SIGNATURE Authorised by: PRINT NAME Authorised by: SIGNATURE
4 EXPENSES CLAIM FORM (EXP1) Incurred by: PRINT NAME claim Internal or external address If you are not an employee, please can you detail your relationship to the University? Payment details (Only required if not a member of staff) UK Bank Sort Code: UK Bank Account No: Travel costs Purpose of journey From To Miles Rate Total mileage 0 (a)
5 Accommodation and other travel related costs Reason for Details of (b)
6 Other expenses Details of expenses Coding (c) Account Cost Centre Job/Project DA SC TC Section totals (a+b+c) Grand total Declaration I declare that the expenses claimed are in accordance with the approved scales of payment as set out in the University's Financial policies and procedures and that no other claim has been or will be made for this from the University or any other organisation. The claim for subsistence is not in excess of the actual costs incurred. Certification I certify that the expenses claimed were necessarily incurred on University business and comply with the University's Financial policies and procedures. Where receipts are required under the University's Financial policies and procedures I confirm that the original copies are attached, have been checked and are legitimate. Claimant: SIGNATURE Where paid in cash: SIGNATURE Authorised by: PRINT NAME Authorised by: SIGNATURE
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