Form - LDAC - Long Distance Fisheries Advisory Council

Reimbursement form

Meeting details

Meeting name(*)

Please enter the meeting's name

From(*)

Please enter the starting date

To(*)

Please enter the ending date

Allowance

Number of meeting days(*)

Please enter the number of meetings days

Meals included

Please enter the number of meals included

Total

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Hotel

Country

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Number of nights in hotel bill(*)

Please enter the number of nights of hotel

Hotel bill (in €)(*)

Please enter the cost of your hotel

Max hotel reimbursement

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Transport

Arrival

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Departure

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Distance

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Boat cost

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Bus cost

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Plane cost

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Train cost

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Reimbursement

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Car plate number

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Are you travelling in economy class?

YesNo Invalid Input

Why not economy?

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Bank details

Full name(*)

Please enter your full name

Organization(*)

Please enter your organization's name

Account name(*)

Please enter your account's name

IBAN

Please enter your account's IBAN

Swift code(*)

Please enter your account's swift code

Documents

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Signature(*)

Please add an image of your signature (png, jpg)

Estimated reimbursement

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Email(*)

Please enter your email address

I HEREBY DECLARE ON MY HONOUR THAT THE INFORMATION PROVIDED ABOVE IS ACCURATE AND THAT I HAVE NOT RECEIVED AND SHALL NOT RECEIVE ANY REIMBURSEMENT FROM ANY OTHER ORGANIZATION OR INDIVIDUAL IN RESPECT OF THE SAME TRAVEL OR SUBSISTENCE EXPENDITURE CLAIMED. You need to accept these conditions to send the request.