17/10/2014 BE MUNDUS - Reimbursement Request

BE MUNDUS
Reimbursement Request

I, Herick Rodrigues Araújo, selected within the framework of the BE MUNDUS Project, coordinated
by Università degli Studi di Roma "La Sapienza", to undertake a Undergraduate (mobility) at
University of Zagreb, inform that I had additional expenses subject to reimbursement according to
what is established in the BE MUNDUS Scholarship Holders Guide:

Expenses

Type of expense: Regulation of the temporary stay permit

Amount claimed for reimbursement in the original currency: 754,15 KN
Expense date: 07.10.2014
Annexes:

For this purpose, I enclose the original receipts and require the transfer of the amount to be done
to my bank account, whose details are indicated below.

Name of the bank Privredna Banka Zagreb

Address of the bank Poslovnica 116 Racki, Rackoga 6, Zagreb
Bank account number HR85 2340 0093 1111 6147 0
IBAN HR85 2340 0093 1111 6147 0
BIC/SWIFT code PBZGHR2X
Other relevant bank details Currency Kuna

Name: Herick Rodrigues Araújo

Date: October 17th 2014

Signature: ___________________________________

IMPORTANT: All the annexes mentioned above must be uploaded together with the signed
version of this document.

This project has been funded with support from the European Commission.
This communication reflects the views only of the author. The Commission cannot be
held responsible for any use which may be made of the information contained therein.

http://bemundus.eu/doc_reimbursement/show?print=1 1/1