CUPE LOCAL 1936 COMMUNITY SOCIAL SERVICES OF GREATER VANCOUVER Mileage Reimbursement

Name:	Phone:	Date Submitted:

Address:	____________________________________________________________________________________________________

(include postal code and ensure it is legible)

Unit #: 1936 - ______ Personal Email Address: __________________________________________

Date mileage incurred	Location: From	Location: To	Location: To	Location: To	Purpose	KM	.55	TOTAL
.72
.72
.72
.72
.72
.72
.72
.72
.72
.72
.72
Sub- Total
TOTAL of all pages ___

Distribution of Charges (office use only)
Purpose	$
04	Operating Expenses
05	Special Purchase
06	Executive Expenses
07	Bargaining Committee
08	Grievances / Arbitration
09	Committee
10	Convention / Conferences
11	Education
12	Donations / Gifts
13	Other
TOTAL

CERTIFICATE

This is to certify that the amounts shown on this statement were

Incurred by me on behalf of CUPE and/or its Local No. 1936

Member Signature:	______________________

Payment recommended by:

Approved by:

Paid by Cheque No.:

Total of Cheque : _____________________# of pages__________

Date:	Submit to: Local 1936 Treasurer

#208-800 McBride Blvd. , New Westminster, B.C. V3L 2B8

Submit to OR email: sec.trea1936@gmail.com

#208 -800 McBride Blvd., New Westminster, B.C. V3L 2B8

Fax: (604) 777-0297 Phone: (604) 522-8445