Revised April 2022

 

EARC MEMBERíS EXPENSES Ė CLAIM FORM (Print and send to Club Treasurer)

Memberís Name and Address

 

*Memberís Bank Details

 

 

Name on Account:

 

 

 

 

Account Number:

 

 

 

Sort Code:

 

 

DETAILS OF CLAIM

Mileage (35 pence per mile)

Date

Details of Journey

No of Miles

Amount Claimed

 

 

 

£

 

 

 

£

 

 

 

£

Date

Details of Incidental Items (please attach receipts)

 

 

£

 

 

£

 

 

£

Total Amount Claimed

 

 

††††††† Signature:

Date:

*Only provide your bank details if you have not provided them previously and you want to be paid by electronic bank transfer.

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