Antrag auf Reisekostenvergütung Bitte beifügen: RKA 10 / 2013 Original der Dienstreisegenehmigung bzw. bei Nichtbediensteten Reiseauftrag, Flugscheine, Belege, Rechnungen und Lieferscheine über Fahrkosten, Nebenkosten, ggf. Übernachtungskosten, sowie Zahlungsnachweise, ggf. bei Zuschussbewilligung Kopie der Zusage not employed by JGU Family name, first name, title / position personell no. (if available): 83564783 Mouse, Mickey, Dr. employed by JGU Institute, working group Telefon / Telefax: private address (street, house-no., zip-code, city) E-Mail: 06131 39 23652 Inst. f. Physik, Komet 8 [email protected] Mäusestr. 26, 36824 Entenhausen IBAN (international Bank account number, 22 digits): name of your Bank: BIC (bank code, 11 digits): Dagobank Scrooge McDuck DE12500105170648489890 PBNKDEFF allowance received from third party advance payment received maximum amount to be reimbursed € /r flight was booked through Carlson Wagonlit Travel (CWT) using direct charge to the AirPlus-credit card. flight train ticket accomodation was direktly payed by ??? I am aware, that I have to use frequent flyer miles acquired on business travels for other business travels. Mainz, 07.05.2014, I declare that the information given in this form is correct. (City) 2014 Year: Course of the journey month Day times Mai 01. 09:00 starting date Mainz Duckburgh Mai Mai Mai Mai use additional sheet if driven with you (names) / necessary km outward journey: attach receipts km Euro conference fee: 120,00 44,67 DD at destination: city bus: 2x 3,50 hotel : 180,00 (69 Duck Dollars) ending time of the journey Was the travel connected to persons travelling attach receipts / travel documents train: 85,00 15:00 arrival (date) 16:00 starting time of the business 19.00 ending time of the business 20.25 return journey from (city of departure): Duckburgh to (destination): Mainz means of transport: Bahn distance weight of baggage Euro means of transport (e.g. Flug (flight), Bahn (train), Auto (car): additional charges if you took a car reservations from (city of departure - has to be Mainz): 01. 01. 04. 04. (signature) travel expenses, (if you visited several business destinations, use extra sheet) to (destination): M.Mouse (Date) return journey: explanations (e.g. why you used a taxi or car rental): a private stay: X no yes from till per diem I renounce any per diem I renounce the per diem except the breakfast included in the accomodatin) free meals received at the hotel or conference. please tick the respective days: X X3 X4 breakfast 1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 lunch 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 dinner 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Accomodation / accomodation allowance (abroad) I renounce accomodation allowance free accomodation (e.g. included in the conference fees) reimbursement with receipt accomodation costs, breakfast included accomodation costs, half/full board included The booking of the accomodation was done through CWT yes no yes no - if yes, please add list of meals myself * host other* *In this case add explanation why accomodation costs were necessary. Just for business travel abroad borders crossed: place Mousetown place Did you have lunch in a canteen? Disneyland country date exchange rate (add proof) 01.05.2014 (for flights: landing time) time date time no yes, from till - chtbedienstete / r dienstete / r llig): s Antragstellers) sten zblatt benutzen Zahlungse beifügen Euro : 29 30 29 30 31 29 30 31 ert auflisten - s* unkt der Landung) tt benutzen) 31
© Copyright 2024 ExpyDoc