SLSGB Expenses Claim Form

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					SLSGB Expenses Claim Form                                                                     SLSGB Expenses Claim Form

Name …………………………………… Position ……..………………………………                                           Name …………………………………… Position ……..………………………………

Reason for claim ………………………………………………………………………..                                          Reason for claim ………………………………………………………………………..

Date of event / travel ……………………………………………..                                              Date of event / travel        …………………………………………….
Travel Details         ……………………………………………………                                             Travel Details         ……………………………………………………
                       …………………………………………………….                                                                   …………………………………………………….


Total Miles ………….. at mileage rate of ….…… p/mile                    £………….……..         Total Miles ………….. at mileage rate of ….…… p/mile                     £………….……..

Passengers ..…. at additional mileage rate of …….. p/mile            £………….……..         Passengers ..…. at additional mileage rate of …….. p/mile             £………….……..

Rail Fare ……………………………..                                              £………….……..         Rail Fare ……………………………..                                               £………….……..

Accommodation …………………………..                                           £………….……...        Accommodation …………………………..                                            £………….……...

Food ………………………………………                                                 £…………………           Food ………………………………………                                                  £…………………

Other ……………………………………..                                               £…………………           Other ……………………………………..                                                £…………………

                                                       TOTAL         £…………………                                                                  TOTAL          £…………………

                                                                                        I wish to gift aid this expense claim to the SLSGB; I am a UK taxpayer
I wish to gift aid this expense claim to the SLSGB; I am a UK tax payer                 (delete as appropriate)
(delete as appropriate)

                                                                                        Signed …………………………………………                                Date ……………………….……...
Signed …………………………………………                                Date ……………………….……...
                                                                                        I certify that this is a true account of my expenses
I certify that this is a true account of my expenses



 Authorised by …………………………………………..                              Office Use Only          Authorised by …………………………………………..                               Office Use Only


 Charge Account ……………………………………….                               AOD/Ex02                 Charge Account ……………………………………….                                AOD/Ex02


                                                                          Form No: 33               Revision Date: 01 June 2008