Certified Claim for Expenses
This form can be used to claim reimbursement of travel and subsistence expenses. Supporting forms may also be required – please see notes overleaf for guidance. Please complete this form using clear, block capital letters, sign and date and pass to your departmental office for processing. Once this form has been signed by an authorised signatory, please return to Pay &
Pensions Office, Finance Department, Firth Court, Western Bank, Sheffield, S10 2TN.
Payment is made directly into your bank account Claimant: please confirm the following (tick):
I have already supplied full bank details OR Post held: My bank details are attached
Address: Claimant Signature:
Payroll Number: OR Student Number:
Date Certified statement of claim and purpose for which Foreign Currency Amount
incurred (please specify) ? p
Staff are encouraged to maintain a personal record of all expenses incurred on University business which are reimbursed and for all grants received towards research and travel expenses incurred both in the UK and overseas. The University’s records of payments are the subject of
scrutiny by Revenue & Customs.
Please contact the Tax team on 21517 if you have any queries relating to the VAT code.
For departmental office use only Gross: ?
Cost Centre or WBS Code Expenses Type Code Gross ? p VAT Code
Payment Details (Bank, Building Society or Overseas Account)
(Please complete if you have not already provided this information or the information has changed)
Please sign and date this part of the form and complete 1 option only to tell us which type of account you would like your expenses paying into.
Option 1 – UK Bank