Expense Report: Internet Society (ISOC) Travel Fellowships, p. 1/2
Expense Report: Internet Society (ISOC) Travel Fellowships
Please provide in the template below a detailed overview of the costs incurred while
attending the event. Don’t forget to send the necessary receipts together with this report to
.
The bank details below are needed for the bank transfer. If you have any doubts on some of
these indications, please check with your bank if to make sure the indications are correct in
order not to slow down the reimbursement process.*
Travel Fellowship Estimate Quantity Total Cost (local) Total Cost (USD)
Return economy class airfare
Visa (if applicable)
Ground transportation to/from
home to airport (if applicable)
Ground transportation to/from
airport to hotel (if applicable)
Other (please specify)
Other (please specify)
Other (please specify)
TOTAL
INFORMATION NEEDED TO WIRE FUNDS TO BENEFICIARY'S BANK
Receiving Bank Information
Receiving Bank's Name:
Receiving Bank's Address:
Receiving Bank's ABA, BIC Number or SWIFT code:
Expense Report: Internet Society (ISOC) Travel Fellowships, p. 2/2
Intermediary Bank Information (if applicable)
Intermediary Bank Account Number or Swift Code:
Intermediary Bank’s Name:
Intermediary Bank’s Address:
Beneficiary Information
Beneficiary's Name:
Beneficiary's Address:
Beneficiary's Account Number (where Funds should be deposited) :
Account Name:
Account Currency :
Swift Code or IBAN :
* ISOC pays bank fees for wire transfers; however if the wire is returned because we were
given an incorrect Swift code, ABA, BIC, IBAN, or account number which caused the wire
to be returned or to be routed to an incorrect bank, the beneficiary is responsible for wire fees
to send out a duplicate wire.
Your Name:
Your Signature:
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