Private Car Travel Reimbursement Form

European Judicial Training Network
Réseau Européen de Formation Judiciaire
Demande de remboursement des frais de transports
(en voiture privée)
Claim for reimbursement of travel expenses
(by private car)
Date:
Demande adressée à / Claim addressed to: Hélène Cambron
Objet de la demande / Object of the claim: Claim for reimbursement of travel expenses for the EJTN
Specialised Training on Gathering and Admissibility of Evidence in Terrorism Cases:
Challenges and Best Practices, held at the Judicial Training Institute of Belgium (IGO-IFJ), in
Brussels, from 29-30 May 2017.
Description de la demande / Description of the claim:
Address of departure:
km x 0,22€ / km =
€
Travel by private car: cost of 0,22 EUR per kilometre for a round trip up to a maximum of 1.200 km
calculated on the basis of the shortest route using the following formula: Kilometre claim
km x 2
(in-out) x 0,22 € / km =
Please send your itinerary, you can use: Michelin/Google Internet Maps.
Participants who choose to use their own car remain fully liable for any accidents to their car or to third
parties.
If you shared your private car with others colleagues, please specify their name and username below:
Nom et adresse / Name and address:
Amount :
€
Date and signature:
Réseau Européen de Formation Judiciaire / European Judicial Training Network
(Association Internationale Sans But Lucratif / Non-profit making international organization)
Rue du Commerce 123, B- 1000 Bruxelles ; Tel: +32.2.280.22.42, E-mail: [email protected]