NZIHA EXPENSE CLAIM
NZIHA Reimbursement Form Name
Authorized by
Per Mile Reimbursement
Department
Date Submitted
Total Reimbursement Due
Email
Date
Bank
Bank Acct #
Travel to/ From Expense Reason Expense Detail K'Metres Other Reciept Yes/No NZ Road Distacne Calculator: http://www.tourism.net.nz/new-zealand/nz-driving-distance-and-time-calculator.html
TOTAL CLAIM Attach or Scan receipts as necessary or required when submitting claim. Send to
[email protected]
VALID FROM 2014 (kb)
0.50/km
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Claim Amt
$0.00
NZIHA EXPENSE CLAIM
com
VALID FROM 2014 (kb)
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