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Get NO X-0095 E 2002

Ality Employee no. (4 or 5 digits) Claim in connection with Bank acct. Girobank Dept./ Divisjon Municipality code Tax per cent Amounts claimed SDCode Total expenses from reverse side Overn. stay Incident. expenses 619 614 1084 614 1085 614 1042 614 1042 610 1086 610 1087 Foreign 610 1052 Overnight accommodation supplement No vouchers Foreign 610 1052 GTAS* (domestic) 610 1053 610 1078 610 1056 8-12 hours More than 12 hours Overnight hotel accom. domestic GT.

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