BSIR Expenses Claim Form

Please fill in the claim form and upload the relevant receipts

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Type *

Other

Meeting Attended/Reason for Expenses *

Name *

Centre *

Address *

Telephone *

Email *

Details of Expenses

Amount

Details of Expenses & Amounts

Expense 1 []

Amount 1 []

Expense 2 []

Amount 2 []

Mileage *

Total Claimed

0.00

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Bank Details

Name of Bank

Address of Bank

Bank Sort Code

Account Number

Name on Account

International Transfer

Swift No

BIC

IBAN No

Route / Branch No(USA)

Receipts

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British Society of Interventional Radiology (BSIR)
The Royal College of Radiologists
63 Lincoln's Inn Fields
London WC2A 3JW

Registered Charity: 1198888