Claim/Invoice Form
What type of claim are you making?
*
Please Select
Expense
Mileage
Invoice
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Expense Claims
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Total Cost;
*
In NZD
Bank Account Number
*
Please provide a valid NZ bank account number
Expense Details;
*
Expense List
*
Please select if you are claiming for CSANZ;
*
CSANZ NZ ($1800)
CSANZ Australia ($3000)
CSANZ Perth ($3500)
Other - Non-conference Claim
Receipt;
*
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Please include a number in the filename of your receipts corresponding to your entries in the above list. For international receipts please also include your bank/credit card statement showing the amount in NZ dollars after currency exchange.
Cancel
of
Mileage Claims
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Expense Details;
*
Include travel origin & destination, and reason for travel
Total distance;
*
In kilometres
Vehicle Type
*
Please Select
Petrol
Diesel
Petrol Hybrid
Electric
Total Reimbursement;
*
Payment rate is as per the IRD km rate for business use of vehicles for the current income year
Bank Account Number
*
Please provide a valid NZ bank account number
Supporting Evidence;
*
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Choose a file
Cancel
of
Invoice
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Bank Account for Payment
*
Hours of Work Performed
*
Date of Work/Start Date
*
/
Day
/
Month
Year
Date
End Date
*
/
Day
/
Month
Year
If relevant
Claim Total
*
Type of work performed
*
Education Administration
Marking/Lectures
Council Administration
Meeting
Course Development
Finance
Other
File Upload
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of
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