Revised August 2023
EARC MEMBER’S EXPENSES – CLAIM FORM (Print and send
to Club Treasurer:- Alastair Jack, 12, Glencroft
Road, Newtownabbey BT36 5GD)
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Member’s Name and Address |
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*Member’s Bank Details |
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Name on Account: |
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Account Number: |
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Sort Code: |
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DETAILS OF CLAIM |
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Mileage (45 pence per mile) |
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Date |
Details of Journey |
No of Miles |
Amount Claimed |
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£ |
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£ |
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£ |
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Date |
Details of Incidental Items (please attach receipts) |
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£ |
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£ |
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£ |
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Total Amount Claimed |
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Signature:
Date:
*Only provide your
bank details if you have not provided them previously and you want to be paid
by electronic bank transfer.