Saskatchewan Artistic Swimming: Expense Claim Form

SAS Artistic Swimming Expense Claim Form

Personal Information

Name*

Address*

Position*

City*

Postal Code*

Reason/Event for Expense*

Start Date of Event*

End Date of Event*

Travel

The current SAS mileage rate will be paid by Saskatchewan Artistic Swimming when two or more SAS volunteers travel in the vehicle.
One-half of the current SAS mileage rate will be paid by SAS when only one SAS volunteer travels in the vehicle.
SAS volunteers are expected to car-pool where possible.

Did you carpool with other SAS volunteers?*

If Not Applicable, please explain:

Who accompanied you?

Were you the driver of the carpool?*

Did you drive from another town to meet up with a carpool?*

From (city)

To (city)

Mileage Distance (km)

Travel Reimbursement

Mileage rate is currently $0.50/km
* Reminder: It is Saskatchewan Artistic Swimming's policy to car pool where possible to all events

Meals

# of Breakfasts @ $11.00

Breakfast Total

# of Lunches @ $15.00

Lunch Total

# of Supper @ $22.00

Supper Total

Total # of meals

Total Cost of Meals

Accomodations

Reservations, where possible, should be at approved hotels/motels at which special rates have been negotiated by Saskatchewan Artistic Swimming.
SAS volunteers are expected to share accommodations where possible. If you choose to stay in your own room or with family/club, reimbursement will be at 50%.

Did you stay in your own room or with family/club?

Who did you room with (first and last name)?

# of Nights

Cost Per Night ($)

Accommodation(s) Total

Accommodation Receipts (Please Attatch)

Other Expenses Total

Other (Please Describe)

Other (Please upload receipts)

Donations

For those wishing to donate some or all of your expense reimbursement, please fill out the form below

I would like to make a tax-deductible donation to support Sask Artistic Swimming

Gifts of $20.00 or more will automatically be receipted.
Charitable Registration #889386868 RR0001
Canadian Council of Provincial & Territorial Sport Federations Inc.

Note: Donations of $120/year are eligible for a 20% top up through the Sport Legacy Fund Donor Incentive Program

Please transfer the following amount from my expense claim and apply my donation to the category chosen below.

Donation Amount Type*

ALL my expense claim amount

PORTION of my expense claim

NONE of my expense claim

Portion Amount ($)

TO (please insert %)

Athlete Support & Development (%)

Coach Support & Development (%)

Officials Support & Development (%)

General Donations (%)

Expense Form Total

Don't fill this field!