Reimbursement form / refusjonsskjema

Your name(Required)

Email(Required)

School / organization(Required)

Name of activity/event(Required)

Start date(Required)

End date(Required)

The reimbursement goes to your own bank account(Required)

Yes

No, to someone else

International or Norwegian bank account?(Required)

Please select "international" if the bank account is not Norwegian.

Name of account owner(Required)

The name of the person or organization who will receive the bank transfer

Your address(Required)

Street Address City ZIP / Postal Code Country

Address of account owner(Required)

Street Address City ZIP / Postal Code Country

Bank account number(Required)

International bank account number (IBAN)(Required)

Please make sure this is a bank account which can receive international payments

Swift/bic(Required)

Name of bank(Required)

Country(Required)

Account Currency(Required)

Are the expenses only your own?(Required)

Who else is covered?(Required)

Please specify the name(s) of people included in this reimbursement form

Utlegg

Type utlegg	Vennligst spesifiser	Kostnad i norske kroner	Vedlegg (kvittering)	Actions

There are no expenses.

Expenses

Type of expense	Details of expense	File	To be reimbursed (EUR)	Actions

There are no Expenses.

Payment reference

If you want the bank transfer to include a specific reference or comment, please write it here

Total (NOK)

Price: Kr 0,00

Total (EUR)

Price: Kr 0,00

Phone

This field is for validation purposes and should be left unchanged.