EXPENSE CLAIM FORM (FOR ECARES/ULB PERSONNEL). Name ... Project
Description. (Dates, places…) ... credit statement for example). For expenses ...
Absolutely necessary to get any reimbursement
Université Libre de Bruxelles av. F.D. Roosevelt, 50 - CP 114/04 B-1050 Bruxelles - BELGIUM
Tel: 32 (0)2 650 41 38 Fax: 32 (0)2 650 44 75 E-mail : R42.6.215
EXPENSE CLAIM FORM (FOR ECARES/ULB PERSONNEL) Name Supervisor Subject Project Description (Dates, places…)
Conference
Seminar
Other:
Financing Ticket paied by “bon vert”* “Autorisation de mission”* FNRS Letter (or other financing)**
Yes - No Yes - No Yes - No
Expenses in EURO proof of expenses Description
Dates
Amount Original receipts
Bank statements
1
Yes - No
Yes - No - cash
2
Yes - No
Yes - No - cash
3
Yes - No
Yes - No - cash
4
Yes - No
Yes - No - cash
5
Yes - No
Yes - No - cash
6
Yes - No
Yes - No - cash
7
Yes - No
Yes - No - cash
Total Expenses OTHER CURRENCY proof of expenses Description
Dates
Amount Original receipts
Bank statements
8
Yes - No
Yes - No - cash
9
Yes - No
Yes - No - cash
10
Yes - No
Yes - No - cash
11
Yes - No
Yes - No - cash
12
Yes - No
Yes - No - cash
13
Yes - No
Yes - No - cash
14
Yes - No
Yes - No - cash
Total * Please attach the copy of the document requested ** The original document is requested Thank you to enclose all the original invoices, copies of bank or visa statements, boarding passes and any other information justifying your expenses.
1
For first request, thank you to complete the following information :
-
NISS number :
Or ULB roll number :
Address in Belgium :
Belgian Bank account : BE
Street : --------------------------------------------------------- Number : -------Zip code : ------------------------------ Town : -------------------------------------
Some information to help you :
REIMBURSEMENT Can be done only with original receipts related to research. Proofs of payment have to be enclosed (copy of credit statement for example). For expenses incurred abroad (visits, conferences, etc…) : please, don’t forget to enclose a copy of your « autorisation de mission » if you are on the payroll of ULB, it is compulsory. TRAVEL You have to give us your e-tickets and boarding passes back, train tickets, even if it was prepaid by ULB (bon vert). Thank you to always enclose your « autorisation de mission » if you are not on the payroll of ULB (see tattached). Muriel Cogghe (
[email protected] - 02 650 48 53) can help you to get it. VISITORS EXPENSES (SEMINARS, CONFERENCES AND RESEARCH VISITS) Claude ADAN has a form with the information the visiting professor has to provide us. INVOICE The invoice has to be addressed correctly, otherwise ULB cannot pay. For reminder, here are important information to be mentioned : ULB - Service Achat av. F. D. Roosevelt, 50 - CP 150 1050 Bruxelles BELGIQUE VAT : BE0407626464 DOCTORAL RESEARCHERS Expenses will be paid or reimbursed only with the agreement of your promotor.
2
