CHARITY REIMBURSEMENT FORM

    REF: Virtual Laughter Muscle Dream Programme

    DATE: Tuesday 22nd December 2020

    PAYMENT MADE BY: The Muscle Help Foundation

    PAYMENT AMOUNT: £

    £15.00 p/head (x4 people) takeaway allowance

    RECEIPT PROVIDED? Y/N

    NOTE: the charity will require a receipt. Reimbursement can only be made once a receipt has been received

    TAKE-AWAY SUPPLIER:

    Provide supplier name & address

    COMPLETE THE INFORMATION BELOW:

    ACCOUNT NAME >

    ACCOUNT NUMBER >

    SORT CODE >

    SPECIFY IF PERSONAL or BUSINESS A/C >

    ACKNOWLEDGEMENT – RECEIPT OF FUNDS

    REF: VLMDP/22.12.20

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