Facilitated Meeting for former residents of Mother and Baby Homes, Clayton Hotel Silver Springs, Cork - 06th October 2017

All information shared on this form will be handled in accordance with data protection legislation and used only for purposes related to this event.

Anyone travelling from afar should contact the Department in advance of booking any travel arrangements.

Travel Cost Claims

Name:Date:__/___/_____

Telephone No:

Address:______

Details of Journey

Mode of Travel: Car  Train Bus  Taxi Aircoach Taxi

Date of arrival:Date of Departure:

Return Journey: Yes No

Distance Travelled (Only if by Car) @ 26c per mile: ______miles

Cost of Travel*:

*ALL RECEIPTS RELEVANT TO THE CLAIM MUST BE ATTACHED

*ONLY VOUCHED CLAIMS WILL BE PROCESSED

I hereby certify that these expenses were incurred by me attending this event and no further claim will be made against any other organisation in relation to these costs

Print Name in Block Capitals:

Signature

Information for Persons Claiming Travel Expenses toFacilitated Meeting in Cork on the 6th October 2017

Please refer to the information below when completing your Travel Claims Form, as incorrectly completed forms will lead to a delay in refunds being processed.

  • Personal details
  • Name
  • Address
  • Email address (for remittance)
  • Phone number
  • PPSN (PPSN is necessary in order to check tax clearance, without which the payment cannot be made by the Department. If name is not the same as that on claims form, written explanation is needed to confirm identity)
  • New Supplier Form (Finance Unit)
  • Name of Bank
  • Address of Bank (address of the branch where the account was opened, this is not always yourlocal branch address)
  • Account Holders Name (as with PPSN, if name is not the same as that on the claims form, a written explanation is needed)
  • BIC (Bank Identifier Code)
  • IBAN(International Bank Account Number)
  • Confirmation of Bank Account Details Page(complete and sign)
  • Signed Travel claims form
  • Signed Finance Unit New Supplier page
  • Details of journey(a summary of the travel being claimed for)
  • Receipts for journey(receipts for travel to the meeting must be supplied on the day and receipts for journey from the meeting to be sent to MBH Unit within 7 working days (Tuesday 17th October) to ensure claims are not delayed during the processing period)

Each claimant must be set up as a New Supplier to the Department of Children and Youth Affairs, which means that, fully completed, claim applications can take longer than usual to be processed and the funds transferred electronically.

We ask that you ensure that personal and bank details are correct and that all receipts are attached to the claims form so that the claims process is not delayed unnecessarily in any way.

Finance Unit New Supplier Form

Please provide the following details when you engage any new supplier.

Name of Supplier
Address of Supplier
Name of Bank
Address of Bank
BIC
IBAN
Account name
Tax Clearance Cert number
or
Charitable Status No (CHY)
Tax Clearance Cert expiry date
Tax Reference Number or PPSN
VAT No. / N/A
Supplier phone number
Supplier email for remittance advice
Contract details e.g. once off purchase, year long contract etc / N/A
Procurement procedure used e.g. EU tender, National tender, 3 quotes / N/A

Signature: ______

Please complete and sign the below Confirmation of Bank Details Form

Confirmation of Bank Account Details:

Name of Bank:

Address of Bank:

Account Holders Name:

BIC:

IBAN:

Signature:

1