Declare my purchase

I want to declare my purchase

Fill out this form if you want to declare you purchase for INPUT.

"*" indicates required fields

Name*

E-mail*

Committee*

Event / Activity*

Bank account name*

IBAN*

Date of purchase (1)

Description and quantity (purchase 1)*

Price of purchase (1)*

Date of purchase (2)

Description and quantity (purchase 2)*

Price of purchase (2)*

More items

Total €*

Receipt*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 12 MB, Max. files: 3.

Note: if you have more than one receipt, please put them into one document and upload them together.

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Name

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