Expense Reimbursement Form

Please check your email account for the confirmation before resubmitting your application

You will now be required to submit this form electronically and it is mandatory to attach electronic copies of receipts and/or approvals to this form. Please have electronic copies (PDF, JPG, GIF, etc) of receipts and/or approvals before commencing.

Basic Details

First Name

Surname

House No and Street Name

City/Suburb

State

Postcode

Country

Phone

Your Email

I am a

Reference

(Enter Student Number or Creditor Code if known)

Reason for Expense Claim

Bank Account Details

Bank Account [Country]

Australian
Overseas

Bank Name

Account Holder

BSB -

Account Number

(enter NUMBERS ONLY without spaces, dashes or any other special characters)

Branch Name

Branch Address

City/Suburb

Postcode

State

Country

Preferred currency to be paid in

Branch Swift Code

Bank Account Number / IBAN

(Mandatory IBAN for European countries only)

Routing Number or Branch Code

(Mandatory Routing Number for Canada/USA only)
(Mandatory Branch Code for NZ/South Africa only)

General Expense Claims

INSTRUCTIONS: For each expense claim, you MUST enter the Expense Date (dd, mmm, yyyy), Claim Type, Claim Description, Currency and Amount Claimed (numbers only, no signs) for your application to be approved. Enter the Cost Collector only if you have been supplied with one.

(Maximum of 10 claims per form)

Expense Date	Claim Type	Claim Description	Currency	Amount Claimed	Cost Collector or G number (if known)

Private Motor Vehicle Use

INSTRUCTIONS: For private motor vehicle claim, you MUST enter the Date of Last Use (dd, mmm, yyyy), Car Registration Number, Engine Capacity, Total Kms Claimed and Purpose of Journey for your application to be approved. Enter the Cost Collector only if you have been supplied with one.

Date of last use	Car Registration Number	Engine Capacity	Total Kms Claimed	Purpose of Journey	Cost Collector or G number (if known)

Important

There must be at lease one General Expense Claim OR a Private Vehicle use claim.
Attach receipts for each General Expense Claim.
Attach written approval by University Contact for private vehicle use (can be an email).
You can submit one attachment with multiple pages OR multiple attachments of a single page.
Expenses will not be reimbursed without all receipts and/or relevant approvals attached.

Attachments

(Maximum of five attachments per form, limit of 1MB per attachment)

Attachment Description	Attachment

University of Newcastle Contact

Contact Name

Staff Directory

College/Division

Unit/School

Phone

UON Contact Email

Claimant Declaration

By submitting this form, I declare that the expenses claimed is for the purpose of conducting business with/for the University of Newcastle and is true and correct in every detail.

I agree with the above Claimant Declaration

Please only press the submit button once. The form may take a few minutes to process depending on the size of the supplied attachments.

The University of Newcastle acknowledges the traditional custodians of the lands within our footprint areas: Awabakal, Darkinjung, Biripai, Worimi, Wonnarua, and Eora Nations. We also pay respect to the wisdom of our Elders past and present.