The following form may be used to file for travel or other legitimate Maritimes Region Y's Men  expenses. Upon submission, this form will be sent to the Regional Treasurer. Note that all claims are subject to the approval of the Regional Treasurer and the Regional Director. To ensure speedy processing please make sure all relevant data is included. 

All Receipts are to be retained for scrutiny should they be requested.

 Date Expenses Incurred

Name of Claimant and Title( ie. RSD, DG,  etc)

Name of Claimants Home Club   

Street Address

City/Town

Province

Postal Code

Description of Expenses Incurred:

1. Travel    Auto: Kilometers at 30 cents per kilometer =  $

           Other ( ie. bridge fees, etc.) State particulars amount $

2. Accommodations:                Location Amount $

3. Meals                                                                                                     $

4. Other Expenses         State Particulars   amount $

                                                                                    Total of all expenses $

If you are combining several activities into one claim please describe below what the "break-down" is for each activity including the expenses allocated to that activity:

        1.

        2.

        3.

If you would like a copy of this claim for your records click on the submit button below. A consolidated summary will be shown. You can then go to your File menu and print a copy for your files.