2014 Athlete Prize Money Claim Form

In order to claim prize money from the European Triathlon Union (ETU) the athlete has to give his/her full and correct address and bank details in clear and legible writing. If incorrect information is provided, a bank transfer of prize money will not be possible. Please note that ETU are only able to pay out prize money after receiving this form from either you or the Local Organiser.

Name of the event:

Athlete’s data (necessary for bank wire transfer) – please ensure all information is correct.

Name and first name
Postal address
Home address
Contact phone number
Email address
Name and address of the account holder (if different from above)
Name of the Bank
Bank address
IBAN or Account Number
BSB or SWIFT Number
Correspondent Bank SWIFT (if required)
Correspondent IBAN / Account (if required)

Place and date: ______signature of the athlete:______

To be filled out by ITU/ETU official:

Result/rank:______Amount of Prize Money in EUR: ______

Signature of ITU/ETU official: ______

Please send this claim form to the ETU office:

ETU Office, for the attention of Kathleen Smet, Kroonstraat, 72, 3581 Beverlo, Belgium, Tel: +32 471 24 40 98 or email it to

Version 07/2010