Declaration form

Claim The Money You Spent

Full Name

Phone Number

Committee

Choose the corresponding foundation

NOTE! If you don't know what the corresponding foundation is, choose 'Industria'

Bank Account Number (IBAN)

Type of Declaration

NOTE! If you don't know what type of declaration you have, choose 'Other'

Number of People (present at the dinner (board responsible included))

Number of People in your committee (board responsible excluded)

Contribution from Industria (You will receive €22.50 incl. VAT per committee member (board responsible included) from Industria)

Contribution from Industria (You will receive €25 incl. VAT per sweater (board responsible excluded) from Industria)

Total Amount on the Receipt

Total Amount on the Receipt (incl. VAT)

NOTE! If the total amount on the receipt (incl. VAT) is higher than 100 euros VAT can not be returned.

Amount excl. VAT over which 9% VAT is taken

Amount excl. VAT over which 21% VAT is taken

9% VAT Clothes

21% VAT Clothes

Contribution Clothes BTW (21%)

Clothes 21% VAT

Total VAT Committee Clothes

Total Amount on the Receipt (excl. VAT)

Return Dinner

Amount to be returned

Is your receipt from outside the Netherlands?

Yes No

NOTE! Fill in the declaration in euros and add a screenshot of the bank transfer next to the receipt in the next step!

Do you want to declare everything that is on the receipt?

Yes No

NOTE! Clearly add in the description what parts of the receipt you want to declare! Fill in the total amount you want to declare (not everything!!)

Do you want to declare multiple receipts?

Yes No

Description of Declaration 1

Image Route (take a screenshot of the route in google maps)

I traveled:

Number of Kilometers (according to the previous screenshot, multiply by two in case you traveled back and forth)

Amount to be returned (You will receive €0.21 per driven kilometer from Industria)

NOTE! It is not possible to reclaim tax on alcohol, so if you have a receipt that contains alcohol make sure to count for this expense 0% VAT instead of 21% VAT.

Total Amount on the Receipt (incl. VAT)

NOTE! If the total amount on the receipt (incl. VAT) is higher than 100 euros btw can not be returned.

Amount excl. VAT over which 9% VAT is taken

Amount excl. VAT over which 21% VAT is taken

9% VAT

21% VAT

Total Amount on the Receipt (excl. VAT)

Description of Declaration 2

Receipt 2 (incl. VAT)

NOTE! If the total amount on the receipt (incl. VAT) is higher than 100 euros btw can not be returned.

Amount excl. VAT over which 9% VAT is taken

Amount excl. VAT over which 21% VAT is taken

9% VAT

21% VAT

Receipt 2 (excl. VAT)

Amount to be returned

Total Amount Declaration (excl. VAT)

Total VAT (9% VAT)

Total VAT (21% VAT)

Total VAT

NOTE! Make sure you have a readable receipt, preferably with the VAT stated on the receipt. If you want to declare only part of the receipt, make sure to strikethrough all the costs on the receipt that you don’t want to declare.

NOTE! Select all the images at once, instead of uploading them seperately if you want to upload multiple.

Receipt (take a clear image of the receipt)

Receipt 2 (take a clear image of the receipt)

Screenshot bank transfer (take a clear image of the bank transfer with the currency rate)

Screenshot bank transfer 2 (take a clear image of the bank transfer with the currency rate)

Signature

The declaration form has been filled in completely and truthfully by me.

Declaration form

Study Association Industria

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