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Reimbursement Request Form

Why we ask for this information

When we send money internationally, banks have to follow rules that help prevent fraud and money laundering. By collecting the full account details, we make sure your refund reaches you safely, without delays, and in line with these regulations.

Full Name

Email

Recipient’s bank account details

Recipient’s full name

Recipient’s home address

Recipient’s country of residence

IBAN (International Bank Account Number)

SWIFT/BIC code (Bank Identifier Code)

Bank name

Bank address

Expense Details

Date

Description

What did you buy? E.g. lunch, train tickets)

Amount

Currency

Receipt

Accepts .jpg, .jpeg, .png, .pdf files

Purpose of expense

Who has authorized this expense?

Declaration

I hereby declare that the information provided above is true and correct to the best of my knowledge and belief. The expenses incurred are for legitimate purposes, and all receipts attached are genuine.

Signature