1

FORMULAIRE de
REIMBURSEMENT FORM REMBOURSEMENT
INDIVIDUAL INDIVIDUEL

Please write in CAPITAL letters Prière d’écrire en MAJUSCULES

PLEASE SUBMIT THIS FORM NO LATER THAN ONE MONTH AFTER THE MEETING
MERCI D’ENVOYER CE FORMULAIRE AU PLUS TARD UN MOIS APRES LA REUNION
MEETING/
RÉUNION European Youth Forum ‘Event Management Training’
ARRIVAL DATE/DATE HOUR/HEURE DEPARTURE DATE/DATE HOUR/HEURE
ARRIVEE 13.07.2023 19:00 DEPART 15.07.2023 17:00
Name
N Julia Kwaśniewska
om
Łęg-Witoszyn 9 kwasniewskajulia800@gmail.com
87-811 Fabianki
Address/ Adresse e-mail

Please attach all the receipts / Veuillez joindre tous les reçus s.v.p.
Type of costs/ Currency Euro
N° From/De To/A Date Price/Prix (To be filled by
Type de frais /Devise the Secretariat)
1 Train Warszawa Lublin 13.07.2023 27,85 PLN

2 Train Lublin Włocławek 15.07.2023 45,36 PLN

I certify that the above statement is true, and that these costs are not being reimbursed from any other source.
Le soussigné certifie sur l'honneur l'exactitude de la présente déclaration et ne pas percevoir de remboursement
par une autre organisation.

Signature ______________________________________ Date _________________________

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with all applicable Data protection and privacy laws, including the "GDPR" (Regulation 2016/679 of 27 April 2016 on the protection of individuals to with
regard to the processing of personal Data and the free movement of such Data).
Read our Privacy Policy here [https://www.youthforum.org/privacy-policy].

TO BE COMPLETED BY THE SECRETARIAT. REFERENCE

PRICE

TOTAL TO BE BUDGET LINE

REIMBURSED EURO
FINANCES

APPROVAL (initials): DATE

Comments: NUMBER
 INSTRUCTIONS FOR REIMBURSEMENT

PLEASE CHECK THE FOLLOWING INSTRUCTIONS BEFORE SENDING YOUR REIMBURSEMENT

FORM TO THE EUROPEAN YOUTH FORUM!!!

YOU WILL ONLY BE REIMBURSED IF:

✓ YOU SEND YOUR REIMBURSEMENT FORM TO THE YFJ SECRETARIAT WITHIN ONE MONTH AFTER THE
MEETING.
✓ YOU ATTEND 80% OF THE MEETING.

✓ YOU FILL IN ALL THE REQUIRED FIELDS WITH A PEN AND IN CAPITAL LETTERS,

✓ YOU PERSONALLY DATE AND SIGN THE REIMBURSEMENT FORM.

✓ YOU ATTACH ALL YOUR BOARDING PASSES.

✓ YOU ATTACH ALL ORIGINAL AND READABLE TICKETS AND RECEIPTS/ INVOICES (NO SCAN! NO
COPIES!)
✓ THE EXPENSES’ RECEIPT CLEARLY MENTIONS THE DATE AND PRICE.

✓ YOUR MEMBER ORGANISATION IS CLEARLY MENTIONED.

✓ YOUR FULL BANK DETAILS ARE ATTACHED IF YOU ARE NOT FROM A MEMBER ORGANISATION.

CAN ONLY BE CLAIMED AS AN EXPENSE:

✓ TRAVEL COSTS FROM YOUR PERMANENT RESIDENCE TO THE MEETING VENUE.

✓ TRAVEL COSTS WITHIN AGREED REFERENCE PRICE.

✓ PLANE TICKETS (2ND CLASS) FOR DISTANCE ABOVE 500 KM.

✓ TRAIN TICKETS (2ND CLASS) FOR DISTANCE LESS THAN 500 KM.

✓ LOCAL PUBLIC TRANSPORT (TRAM, BUS, TRAIN). TAXIS ARE NOT COUNTED AS LOCAL PUBLIC
TRANSPORT.
✓ ACTUAL CAR COSTS UP TO THE COST OF A 2ND CLASS TRAIN ONLY IF ORIGINAL RECEIPTS AND A
PROOF OF THE CORRESPONDING TRAIN FARE ARE ATTACHED.
✓ VISA COSTS JUSTIFIED WITH A RECEIPT AND COPY OF THE VISA STAMP ON THE PASSPORT STATING
THE PRICE PAID.
✓ VISA - TRAVEL-RELATED COSTS REQUIRED TO GET THE VISA (IF ONLY APPROVED BY THE
ADMINISTRATIVE & FINANCIAL DIRECTOR).

REIMBURSEMENT RULES:

● YOU HAVE ONE MONTH AFTER THE MEETING TO SUBMIT YOUR REIMBURSEMENT FORM.

● ONCE THE DEADLINE HAS PASSED, NO REIMBURSEMENT WILL BE DONE. NO EXCEPTION WILL BE
MADE.
● IF THE PRICE OF THE TRAVEL IS HIGHER THAN THE REFERENCE PRICE, ONLY THE AMOUNT OF THE
REFERENCE PRICE WILL BE REIMBURSED.
● WE ALWAYS REIMBURSE THE MEMBER ORGANISATION, NEVER DIRECTLY THE DELEGATE(S).
● METRO/TRAM TICKETS HAVE TO BE PURCHASED SEPARATELY (ONE TRIP AT A TIME). DO NOT BUY A
10 TRIPS TICKET IF YOU ARE NOT GOING TO USE THEM ALL. WE NEED THE ORIGINAL TICKETS PLUS
THE RECEIPTS PROVING THE PAYMENT.
● STAPLE OR TAPE ALL ORIGINAL RECEIPTS ON A4 PAPER AND ATTACH THEM TO THE
REIMBURSEMENT FORM.
● NUMBER ALL THE RECEIPTS ACCORDING TO THE REIMBURSEMENT FORM.

● DO NOT CALCULATE THE EXCHANGE RATE YOURSELF THE SECRETARIAT WILL USE THE RATE ON
THE DAY OF PROCESSING THE REIMBURSEMENT.
● NO CASH REIMBURSEMENT IS DONE AT THE VENUE OF THE MEETING.

● WHEN NOTIFIED THAT THE REIMBURSEMENT FORM CANNOT BE ACCEPTED AS PRESENTED, ONE
WEEK IS GIVEN TO FORWARD THE NECESSARY JUSTIFICATION.

BANK DETAILS - INFORMATIONS BANCAIRES

Individuals - Individus
(attn. Sarah Jane, Accountant - Comptable)

PLEASE WRITE IN CAPITAL LETTERS - VEUILLEZ ÉCRIRE EN MAJUSCULES

NAME - NOM
(Full name of Account Holder) Julia Wiktoria Kwaśniewska
(Nom complet du titulaire du …………………………………………………………..
compte)

Bank name PKO Bank Polski

Nom de la banque …………………………………………………………..

Address of the bank - Adresse de la banque

Ul.Puławska 15, 02-515 Warszawa
…………………………………………………………..
…………………………………………………………..…………

…………………………………………………………………………………………………
……………………….

Code IBAN (for all countries included in SEPA - Single Euro Payments Area)
(pour tous pays inclus dans SEPA - Single Euro Payments Area)

.........................................................................................................................................

SWIFT - BIC
code..........BPKOPLPPW...........................................................................................
Bank Account Number - N° de compte bancaire Bank Code - Code bancaire
.......................................................................... .............................................................

NAME AND SIGNATURE : DATE :

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