EXPENSE CLAIM FORM

Instructions for completing this form:
a.	Please ensure that all sections are completed fully and correctly – (please type directly in the grey boxes)
b.	Please ensure that all requested documents are attached to the claim (see. checklist in annex)
c.	Completed expense claim forms must be sent to the attention of Ms. Hélène Cambron at the EJTN:
-	either by e-mail, at RefundEvent@ejtn.eu ;
-	or by post together with the original reimbursement documents (see. checklist in annex) at European Judicial Training Network, Finance Unit, to the attention of Ms. Hélène Cambron, Rue du Commerce 123, B-1000 Brussels. - no later than three (3) weeks after the seminar.
d.	Please mention the activity number (see below) on the envelope or in the subject line of your email.

I.	INFORMATION ON THE EVENT	

Type of event: Linguistics seminar « Language training on the vocabulary of Competition Law »
Activity number: LI/2016/05
Venue: Judicial Academy of the Slovak Republic, at the Field office in Omsenie (Trencianske Teplice)   
                        Omsenie 820, 91443 Omsenie, the Slovak Republic
Starting date & time: 6 July 2016, 9.00 am
Final date and time: 9 July 2016, 9.00 pm

II.	INFORMATION ON THE PARTICIPANT	

Surname: 	     
First name:	     
Institution:	     

III.	STATEMENT OF COSTS	

Please detail in the table below your expenses related to the event. If your travel costs include several journeys (ie. plane, then train), please detail each journey undertaken according to the example below:

	From	To	Type of cost (including hotel/meals… for national participant)	Cost (in the currency stated in evidence/invoice)	
	Date	Place	Date	Place			
Ex.	30/08/09	Brussels (BE)	30/08/09	Madrid (ES)	Plane	000 EUR	
Ex.	30/08/09	Madrid (ES)	30/08/09	Valencia (ES)	Train	000 EUR	
1.	     	     	     	     	     	     	
2.	     	     	     	     	     	     	
3.							
4.							
5.							
6.							

Declaration
Hereby, I am making a claim for the payment of the sum that is due, as well as the transfer of this amount into the bank account indicated in my registration form or above.

I hereby certify that the information provided is true and correct and that I have not omitted any essential elements.

Done in:      				Date:      				Signature:      

REIMBURSEMENT CHECK-LIST 

Please find below the list of documents required in order to process your reimbursement. These documents should be sent to EJTN as soon as possible after the meeting, and by no later than three weeks following the event. Please confirm whether you have all the requested documents.

Documents to be sent to the EJTN Secretariat after the seminar, addressed to:
Finance Unit
Hélène Cambron
LI/2016/05
European Judicial Training Network, 123 rue du Commerce, B-1000 Bruxelles, Belgium	

PLEASE NOTE THAT ALL ORIGINAL DOCUMENTS MUST BE SENT BY POST.

 Expense Claim Form 
 The following travel documents depending on how you travelled: 	
•	If you travelled by plane:
 The invoice from your airline company/travel agency
 A copy of your itinerary 
 The original boarding passes corresponding to your journey

•	If you travelled by train:
 Your travel invoice
 The original train tickets corresponding to your journey

•	If you travelled by private car:
 The “Claim for Reimbursement of Private Car Travel” Form 
 A Via-Michelin/Google Maps itinerary of your journey, depicting your arrival and departure points (residence to seminar venue) and the number of kilometres covered, calculated on the basis of the shortest route available 

Additionally, participants residing in the country where the seminar is to take place should also provide the EJTN with the following documents: 
 Invoice of accommodation (if not directly paid by the organizers);
 Original tickets and invoices for local transport (train, bus from the airport/train station to the venue, etc.). Taxi costs are, in principle, not eligible;
 Original invoices for meals (except if directly covered by the EJTN and automatically deducted from the per diem).