Claim form for reviewer`s fee and travel expenses

FORM FOR CLAIMING
FEES AND TRAVEL EXPENSES
We strongly recommend that you type or write in block letters.
The signed form and all appropriate receipts can be scanned and sent by email. If you wish to send the documents by
regular mail, please save a copy of the documents.
Evaluation project/Expert task/Review panel
Research council/unit of the Academy of Finland
Last name as in passport
First name as in passport
Male
Nationality
Date of birth (DD.MM.YYYY)
Email
Identity number or Tax Identification Number (TIN)
Female
Home address
Place of residence/Postal code/Country
Telephone
Please fill in all fields below with the complete information regarding your bank connection. Without this information, the Academy of Finland is
unable to complete the transfer.
NB! The reviewer’s fee is personal and paid to your private bank account only.
Bank account number, IBAN if available (IBAN is mandatory for bank accounts in Europe)
Name of the bank
BIC/SWIFT-code / Clearing code/Routing number
Full postal address of bank
Please fill in if you are claiming travel expenses. The fees for the review work and draft reviews will be calculated
automatically by the Academy of Finland.
Travel begun (date)
Travel ended (date)
Means of transportation and other travel expenses in chronological order.
Always justify the use of taxi and private car.
Please note that expenses are compensated based on receipts only.
Date and signature
*) Exchange rates are calculated by the Academy of Finland.
Expenses (and currency if
other than euro*)