RPAP-Expense Claim

							                                                                                                                     University of Calgary Expense Claim Form
                                                                                                                                                                   Form: F-9 Revised: 20 Oct 2008

                                                                            Name:

                                                                 Mailing Address:

                                                                           Activity:

                                                                    Address Changed Since Last Invoice: Yes                  No          Direct Deposit: Yes        No
Tape receipts to an 8.5" x 11" sheet of paper.
  Activity        Description of Expense                            Airfare                Lodging                  Meals                   Other           Vehicle Travel         Total(s)
   Date
(dd/mmm/yy)                                                     Before       GST       Before        GST       Before       GST       Before        GST      KMs      KMs x      Total Amount
                                                                 GST                    GST                     GST                    GST                             .43        (with GST)




             FOR OFFICE USE ONLY                                                                                                                            TOTAL:
      ½ GST:                                                               Claimant Signature:
Amt + ½ GST:                                                                                Date:                                                                         Remit To:
                                                                                                                                                                   Rural Initiatives Program
   Total Amt:                                                                      Prepared By:                                                                     University of Calgary
                                                                                                                                                                   3330 Hospital Drive NW
        Code:                                                                      Approved By:
                                                                                                                                                                    Calgary AB T2N 4N1
 Approved By:
        Date:

    The individually identifiable and financial information on this form is collected by RPAP under the authority of the Personal Information Privacy Act            Tel: (403) 220-4257
      (Alberta). It is used only for the purpose of program administration, and will not be disclosed to anyone other than the claimant or his/her legal             Fax: (403) 210-3986
  representative. This financial form will be retained in compliance with provincial government regulations, and then securely disposed. If you have any
                              questions about the collection, use or disposal of the information requested, please contact RPAP.