Claim No     /

                                       The Churches Together (North East) Football league.

                       

                                    MISCELLANEOUS CLAIM FORM.

.-----------------------------------------------------------------------------------------------------------------------------

DATE.                                        PARTICULARS OF CLAIM.                                AMOUNT OF CLAIM

------------------------------------------------------------------------------------------------------------------------------

            .                                                                                     .        

            .                                                                                . 

            .                                                                                 .

            .                                                                                . 

            .                                                                              .   

            .                                                                                     .

            .                                                                                     .

            .                                                                                     .

                                                                                                net

 

                                                                                                vat

 

                                                                                                Total £

 

------------------------------------------------------------------------------------------------------------------------------

 

I  have paid / wish to reclaim- the above expenses incurred on behalf of the league.

 

Claimant…………………………                                               Date.        /        /200

 

Receipt attached    YES / NO ………………………………………………………………

 

Payment made by Cheque/Cash                                                       Cheque no………

 

Signature of Treasurer………………………………………………….

 

Amount received   £        .     p     Date      /    /200     Signature of claimant…………………..