Submission of travel documents for billing

General Information

Application number *

E-mail *

Please enter the e-mail address, to which the invitation to this form was sent.

Billing

Place of residence *

First place of work *

Please indicate the place of employment where you mainly work.

Account holder

Required if different from applicant's name

No SWIFT/BIC

SWIFT/BIC

No IBAN

IBAN

Details of Trip

Trip from (location) *

Trip to (location) *

Start of journey *

End of journey *

UFZ business appointment start *

UFZ business appointment end *

Private stay start

Private stay end

Travel Expenses

Train ticket (2nd class; 1st class only from 2 hours driving time)

EUR

Local public transport

EUR

Taxi (please justify)*

EUR

Flight invoice (boarding cards are part of the invoice)

EUR

Distance travelled by private car

Rental car (please justify)*

EUR

Accommodation costs¹ with receipt

EUR

Accommodation costs without receipt: number of nights

times

Other expenses (please justify)*

EUR

* Comments and justifications

¹ Accommodation costs incl. breakfast with a receipt can be reimbursed up to a maximum of 75,60 €/night. Alternatively, an accommodation lump sum of 20 €/night can be reimbursed without a receipt.

There were no costs

Meals free of charge

Meals (also during flights or included in hotel costs or conference fees)

Date:

Breakfast

Lunch

Dinner

Attachment: only travel expenses *

Please note that you can only upload one PDF.

I confirm that the digital receipts are unchanged and will be claimed at the UFZ only. Please note that according to current law (BRKG), the right to reimbursement expires after 6 months (starting from the last day of the trip). Travel expenses will be reimbursed according to valid BRKG.

I confirm that the above specified travel expenses are not reimbursed by my employer (e.g. on the basis of an approved business trip or a cooperation agreement with the UFZ) or are covered by any other contractual relationship with the UFZ (e.g. service contract, fee agreement or other assignment).

I have read the privacy policy.

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