SECTION C
Declaration
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.
5. *I de/do not hold a season ticket for the return journey between my
home and my permanent station/duty station.
6. *I do/do not have a standing/temporary imprest.
Signature
I Gaflaths....
Date
3015
ро
нко
Travel and Subsistence Claims Form
All sections of this form should be completed.
SECTION A
Please complete in BLOCK LETTERS
Surname
Forename(s)
GRIFFITHS
TRUDY MAUREEN
Full Private Address.
...(off...
354/1
Sent to
Dept 31/5
ED
Finance
ED
Title (Mr/Mrs/Miss/MS). MIS.S
Grade
S2
40 GREENLAND QUAY
PLOUGH WAY.
SURREY QUAYS
Division/Branch/Project Number.
Postcode...
*delete as appropriate
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.
Signature
Mor Пото
(Authorising officer)
Date
30/5191
Official Duty Station
Temporary/Detached Duty Station
Full Official Address.
HONG KONG WH 306
DEPT.
Name
NJ COX
(BLOCK LETTERS).
For Departments use only
Date received
Rank DS 5(s)
If payment is made by cash the following receipt must be signed Received the sum of
£
Amount (in words)
Tel. number 2.70 264-6
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
Name of Bank
Address of Bank
Examined and Passed
initials and date.
r
Date paid
Printed in the UK for HMSO. Dd. 9013374 2/89 C770 9385 4850
Signed
Date
3. A payment advice for sums paid directly to my bank should be sent to my
*OFFICE/PRIVATE ADDRESS.
29 2021 GS 430 (8-
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