SECTION C
Déclaration
I certify that:
1. I made the journeys detailed in this claim.
2. The expenses shown have been actually and necessarily incurred by me on
the Public Service.
3. The allowances charged comply with the Rules of this Department.
4. (for motor mileage claimants only) I hold a valid driving licence and my motor
insurance policy covers the use of the vehicle on official business.
covers
5. *I do/do not hold a season ticket for the return journey between my
home and my permanent station/duty station.
6. * do/do not have a standing/temporary imprest.
Signature
'delete as appropriate
Date
2/5/91
Sent to Finance Dept 14/5
HKD 354/1
Travel and Subsistence Claims Form
All sections of this form should be completed.
SECTION A
Please complete in BLOCK LETTERS
Surname PAUL
Forename(s) ALAN Full Private Address 14.
ра
Title (Mr/Mrs/Miss/Ms)...R DS4
Grade
Blossom Close, Croydon
Surreal
Postcode C ZEZ
Approval - please check Section B before approving this claim
I confirm that, to the best of my knowledge and belief, the facts given in this claim are correct, that the expenses were actually and necessarily incurred on official business in the most economical manner, and that the allowances charged comply with the rules of this department.
Division/Branch/Project Number.
Official Duty Station..
Temporary/Detached Duty Station
Full Official Address.
Hong Kong Dept, ROOM WH 307.
Signature
Date
14 091
(Authorising officer)
N J сох
Name
Rank
DS5 (5)
(BLOCK LETTERS).
For Departments use only
Date received
Examined and Passed
initials and date....
Date p
Printed in the UK for HMSO. Dd. 9013374 2/89 C770 9385 4850
Tel. number. 270 2647
If payment is made by cash the following receipt must be signed
Received the sum of
£
Amount (in words)
Signed
1. Payment of this claim should be made to my *BANK/OFFICE/PRIVATE
ADDRESS
2. If payment is to be made direct to your Bank please give below your account number and both the name and full address of your bank
Account number 0308027
Name of Bank
Address of Bank
LLOYDS BANK
SOUTH END
CROYDON CRG IYA
3. A payment advice for sums paid directly to my bank should be sent to my
*OFFICE/PRIVATE ADDRESS.
Date
28-2024 GS 430 (formerly A/C's Gen 8)
* Delete as appropriate