Travel Expense Claim Form

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Travel Expense Claim Form

Claimants Name: *

First

Last

Claimants Section: *

Claimants Email: *

Mode of transport: *

Car or van
Motor cycle
Train

Purpose of Travel: *

Rugby Match
Training
Other

Please state purpose of travel: *

Travelling From: *

Address Line 1

City

State / Province / Region

Postal Code

Travelling to... *

Westcliff Rugby Football Club (SS4 1YG)
Other

Address travelling to: *

Address Line 1

City

State / Province / Region

Postal Code

Upload a picture of your train ticket & receipt *

Click or drag files to this area to upload. You can upload up to 3 files.

Max file size 1 Mb

Was the trip one way or a return: *

One Way
Round Trip

Total milage travelled: *

Approved travel expenses will be paid per mile in line with HMRC's published mileage rates of 45p/mile for cars and vans, or 24p for motor cycles.

Total value of the train travel claim (£): *

My Bank Details

Bank details are gathered to facilitate the transfer of money of approved claims. Payments will only be paid to accounts held in the name of the claimant. Westcliff RFC will not accept any liability if incorrect bank details are provided. Please take care in providing correct information.

Bank Sort Code: *

Account Number: *

Declaration

Declaration *

I declare that my submission is true and accurate and that it is my responsibility to make any personal declarations that are requied by regualtion to HMRC .

Signature *

Please draw your signature on the touch screen or by using the mouse. When using a mouse, hold down the left button to draw. You can start again by clicking on the x in the top right corner.

Todays Date *

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