Student, Visitor and Conjoint Reimbursement Form

Overseas bank account

Claim Type
(PO Box is not acceptable)
(IBAN Mandatory for European countries only)
(Mandatory Routing for Canada/USA, Branch code for NZ/South Africa)

Section A - Domestic Travel Click to show $0.00

Cost Collector Account Code GST Code Amount
$
[+] Add another row
Section A Sub-total $ 0.00


Section B - Use of Private Motor Vehicle Click to show $0.00

The rates per kilometre are per the current ATO rates.

Registration Number
Engine Capacity
Kilometres and Rate km @ cents/km = $
Cost Collector Account Code GST Code Amount
$
Section B Sub-total $ 0.00


Section C - International Travel Click to show $0.00

Foreign currency receipts should be converted to Australian Dollars. Foreign currency exchange rates.

Cost Collector Account Code GST Code Amount
$
[+] Add another row
Section C Sub-total $ 0.00


Section D - Other Reimbursements Click to show $0.00

Cost Collector Account Code GST Code Amount
$
[+] Add another row
Section D Sub-total $ 0.00


Claim total (Total of Sections A, B, C, D) $0.00


Claimant Declaration

I certify that the above claim is for University business purposes only and is true and correct in every detail.

Claimant Name Signature X
Date

Approver Declaration

I certify that the above claim has been checked for accuracy and is approved expenditure for University business purposes.

Approver Name Signature X
Position/Title
Date

Please make sure you have completed all the relevant fields before printing