Expenses Claim

Reimbursement of Expenses Claim Form

Form for ARCHERY SA Officers, Officials, State Team members & others seeking reimbursement for APPROVED expenses.

"*" indicates required fields

Claimant*

First name Surname

Email*

Enter Email Confirm Email

Contact Phone*

Membership Number*

Please enter a number greater than or equal to 0001.

Must be a currently financial member

This Expenses Claim is for....*

Travel costs

Accommodation

Other

Date of Expenditure*

Nature of Expenditure*

Details of expenses (receipts/proof of expenditure are required - you can attach electronic copies of receipts/invoices to this claim - see below)

Amount*

insert number and it will convert to $

Date of Additional Expenditure

Nature of Additional Expenditure

Details of expenses (receipts/proof of expenditure are required)

Amount

insert number and it will convert to $

Date of Additional Expenditure

Nature of Additional Expenditure

Details of expenses (receipts/proof of expenditure are required)

Amount

insert number and it will convert to $

TOTAL AMOUNT OF THIS CLAIM*

insert number and it will convert to $ (If you have more claims than this form permits, you will need to complete another form.)

Account Name (payee)*

BSB Number*

no spaces or hyphens (max 6 characters)

Account Number*

CAPTCHA

Proof of Expenditure*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

You must attach copies of any relevant receipts, invoices or other proof of expenditure