Best to Copy & Paste in Word then Print
SOUTHLAND TRAMPING CLUB
email - stctreasurer99@gmail.com
VEHICLE – WORK PARTY CLAIM FORM
Attach receipts to back or scan and email with signed form to the Treasurer
Date: …………………………
Vehicle Owner: …………………………………............................................
Location/Purpose of Trip: ……………………………………………..................
NB: Charging is no more than double the amount of petrol used
Diesel vehicle costs are the same as for petrol, plus the current Road User Charges for that vehicle. (Drivers of diesel vehicles will need to take note of kilometres travelled and exact costing completed when you have returned from the trip and filled up with fuel.)
Petrol/Diesel: $………………….
x 2: $.…………………
Total $..………………..
Kilometres Travelled ....………………..
Road User Charges $...................
Total Claimed: $ ___________
Signature: ……………………………………………………….
Bank Account reimbursement is to be paid to:
___ ______ ______________ _____
_________________________________________________________________________
TREASURER
Date paid : ………………………………………….
Electronic Payment No: ………………… Amount Paid: $ ………………......