Private Car Travel Reimbursement Form

Réseau Européen de Formation Judiciaire
European Judicial Training Network
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: [phone], E-mail: [e-mail]
Claim for reimbursement of travel expenses
(by private car)
Demande de remboursement des frais de transports
(en voiture privée)
Date:
Claim addressed to / Demande adressée à:
Object of the claim / Objet de la demande: Claim for reimbursement of travel expenses
associated with the Human and Fundamental Rights Seminar on “CONFLICTS OF
NORMS IN THE APPLICATION OF FUNDAMENTAL RIGHTS ”, to be held at
Tribunale Amministrativo Regionale, via Flaminia 189, Rome, Italy IT-00196 from 2
to 3 March 2017.
NOTE: The EJTN is only able to reimburse private car journeys up to a maximum of
1.200km (return journey). Please attach to this claim a Michelin/Google Internet Map
depicting your travel itinerary (arrival and departure points, as well as total number of
kilometres travelled).
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 (itinerary mapping in support –
Michelin/Google Internet Maps), using the following formula: Kilometre claim km x
2 (in-out) x 0,22 € / km =
Participants who choose to use their own car remain fully liable for any accidents to their
car or to third parties.
Nom et adresse / Name and address:
Amount : €
Date and signature: