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2024 Mooroopna State Championships - Travel Claim Form

VFBV CFA STATE CHAMPIONSHIPS COMPETING BRIGADE AND OFFICIAL TRAVEL REIMBURSEMENT

Claims for allowance towards transport costs

Brigade Secretary,

Please complete and return this form via

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Save a PDF version, complete and send via email championships@cfa.vic.gov.au
Mail to PO box 701, Mount Waverley, VIC, Australia 3149 (attention Volunteer Sustainability Team)

within four weeks of the competition date. It is regretted that no claim submitted after this date will be considered.

NB: Please complete and submit individual forms for Junior and Senior team claims.

Brigade Name *

Brigade No. *

Full Name *

Which Championship Event is this claim for? *

Urban Junior State Championships
Urban Senior State Championships
Rural Junior State Championships
Rural Senior State Championships

How many COMPETITORS travelled by road to the State Championships? (Number) *

How many OFFICIALS travelled by road to the State Championships? (Number) *

Total travellers (from above) (Number) *

Non-team Members/Supporters (approx.) (Number)

(Attendees that are not competitors or officials are not included in travel claim criteria. This data request is for statistical purposes only and assists with planning for future Championship events.)

If you are claiming for an official / judge from a NON-COMPETING Brigade, please include a Full Name and Championships Role

COMPLETE THIS SECTION IF CLAIMING A KILOMETRE RATE FOR PRIVATE VEHICLES:

How many vehicles were used to transport competitors and officials to the above Championships?**

What was the total number of kilometres travelled (to and from) for one vehicle?***

** The maximum number of vehicles for which the allowance will be made is five (5), on the basis of four (4) competitors per car.

*** Subsidy will be calculated by using the shortest distance by road between your home town and the Championships venue and return.

Private vehicle details

	Vehicle make	Vehicle model	Registration	No of passengers	Sighted copy of insurance? (yes/no)
No. 1
No. 2
No. 3
No. 4
No. 5

The Brigade Secretary certifies that they have sighted the current comprehensive insurance policies of the vehicles which transported members to the State Championships in 2024 and approve the information provided on this form.

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COMPLETE THIS SECTION IF CLAIMING FOR CHARTER/HIRE BUS (PLEASE ATTACH ORIGINAL TAX INVOICES):

Name of Hire Company

Hire Cost (ex. GST)

Fuel Cost (ex. GST)

Total amount being claimed (ex. GST)

Please attach your receipts if required. Alternatively you can email them to championships@cfa.vic.gov.au

List of Allowed file types

The Brigade Secretary approves this travel claim form, and can confirm the information contained is certified and correct.

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NB: Brigades who operate under CFA's corporate ABN may claim the GST component by submitting a GST input Tax Paid Form to your local District Business Manager. Brigades separately registered for GST will need to claim as part of their BAS with the ATO.