/ UEFFEDERAL COMMITTEE MEETING
Brussels, 13-14 June 2014
Representation of the State of
North Rhine-Westphalia to the EU
Brussels, Belgium

TRAVEL EXPENSES

I do not apply for a financial contribution from UEF and my travel expenses can be considered a donation to the UEF

TRAVEL DOCUMENTS DETAILS / Total Cost
Travel / Plane / EUR
Train / EUR
Bus / EUR
Car The journey from my home town to Brussels is km, ONE WAY. / EUR
Mention people travelling with you:
1. / 2.
Hotel / Total number of hotel nights : / EUR
Subsistence / EUR
Other / Please specify: / EUR
TOTAL / EUR
TO BE FILLED BY UEF SECRETARIAT / Total amount to be reimbursed by the UEF / EUR
Total amount of donation / EUR
Full name
Address, postcode, town and country
E-mail
Telephone
Bank
Address, postcode, town and country
BIC
IBAN/account N°

Date, place:Signature:

REIMBURSEMENT REQUEST

EXCLUSIVELY FOR UEF FEDERAL COMMITTEE MEMBERS

Taking the financial situation of the organisation, we would like to limit the payment of effective travel reimbursement to members who feel they could not participate in the Federal Committee otherwise. No travel reimbursement will be paid for travel costs under 100€. Expenses above 100€ will be paid back at a rate of 75% with a maximum of 300€.If travelling by car (min. 2 people), the reimbursement is of 0,13 Euro/km.

Please note that reimbursement will only be given on the basis of original tickets /receipts. If travelling by plane, please include your ticket as well as your boarding pass; if travelling by car, please include your petrol tickets.

!!! PLEASE WRITE IN CAPITAL LETTERS!!!

Surname:

First name:

Home address:

E-mail address:

Phone number:

Reimbursement request:

Name of Bank:

Bank address:

International Bank account number (IBAN):

Swift/Bank Identifier Code (BIC):

Please be extremely careful in writing these account numbers. The banking costs incurred due to errors in IBAN/Swift numbers will be deducted from the total of your refund.

Have you included?

□ Receipt – proofs of payment □ Tickets/Boarding cards

Send this form plus expense form and all proofs of purchase to:

Mana Livardjani

Director

Union of European Federalists

Square de Meeûs 25

B-1000 Brussels

Please note that reimbursements will unfortunately take time and can only be given on the basis of the original tickets and invoices. Deadline for the submission of reimbursement requests is 13.07.2014

Date, place:Signature: