EMC Reimbursement Claim Form

1REIMBURSEMENT CLAIM FORM
Early Modern Conversions Project
McGill University
3610 McTavish St, Office 16-2 (1st Floor)
Montreal, QC H3A1Y2

Please complete and sign this form and submit it along with original receipts to the above
address. All claims for travel expenses must abide by the EMC Travel Policy (see following).
Claimants who do not have a McGill identification number will also have to submit theVisitor Claimant Form (also following).
You must submit all forms with an original wet signature. A scan or a copy will not beaccepted.
Co-Investigators travelling on sub-grant stipends should submit reimbursement requests to theirhome departments and/or institutions, rather than using this form.
All requests must be submitted within 30 days of the last day of travel.
For expeditious processing, please take careful note of the following guidelines:
Receipts
Claimants must provide receipts for all travel reimbursements (with the exception of meals, seebelow). For air, rail or bus travel booked online in advance, please submit the booking
confirmation sent to you from the vendor by email. This will need to show the date ofpurchase and full itinerary as well as proof of payment (usually an indication that fare waspaid in full by credit card, with the last four digits of the card provided). The same would apply
for train or bus tickets purchased in advance. For train or bus fares paid on the day of travel,please submit the purchase receipt (this may be the ticket itself in some instances). For travel
by taxi please submit receipts filled out in full (including the date). As a safeguard, claimants
should photocopy any non-replaceable receipts (e.g., taxi receipts, train tickets) before posting.
Please provide boarding passes whenever possible.
Meals
Claimants do not have to submit receipts for meals. In order to keep costs and administrative
workloads manageable, we will reimburse claimants for meals during periods of travel by way of
per diems when the meals are not included in travel or hotel bookings or otherwise provided byevent hosts. The McGill per diem rates are currently $10 for breakfast, $16 for lunch, and $28
for dinner within Canada, and $12/$21/$37 abroad.
DelayPlease note that the reimbursement process is long and involves several steps anddepartments. Expect at least 2 months for payment to be issued from the moment theprocess has started at McGill. We will not start an inquiry process until it has been more than
3 months since the McGill report was drawn. Depending on volume, this report is usuallycompleted within 2 weeks after the claim and receipts have been received.

EMC Reimbursement Claim Form

NAME OF CLAIMANT*MCGILL ID#DESTINATION CITYPROVINCE/STATEDESTINATION COUNTRYSTART DATE
(E.g. 27-Jan-2015)
RETURN DATE
*If you do not have a McGill ID#, you will also have to fill out the Visitor Claimant Form, see following.

DESCRIBE THE PURPOSE OF YOUR TRIP:(E.g. “Presentation for the ‘Theatres of Conversion’ Workshop at the University of Toronto”).

AWARD TYPE, AMOUNT, AND DATE:
If you are claiming reimbursement deriving from an EMC Award (for example, a Collaboration Fundaward, or a Research Travel & Dissemination Fund award), please fill in the details of the award, please
fill in the details below. If your claim does not connect to an award, you may leave this section blank.

TYPE(E.g., ‘RTD’ or ‘Collaboration’)
AMOUNT(If applicable)
DATE(Approximate date when you
received notice of the award)

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EMC Reimbursement Claim FormTo speed the process of your claim, please list each individual expense in the chart below as
accurately as possible. You must provide a receipt for each item (excluding meals). The date andamount for each entry must correspond to the date shown on the receipt (date of purchase). Do notmake conversions to Canadian funds. All necessary conversions will be made automatically, and willcorrespond to the date listed on the receipt. For per diem meals, please group all costs together as asingle expense and provide a total amount. For per diem amounts, please see p. 1.
Examples for the “expense” column:- Return economy airfare on Air Canada from Montreal YUL to Chicago O’Hare on Sept. 12 (return onSept. 17)- Three nights at Cinderella Hotel in Toronto, Sept 4-7- Per diem: Sept. 3 (1 breakfast @$12 + 1 dinner @$37) + Sept. 4 (1 dinner @37) = $86

ExpenseDate onReceiptAmountCurrency
E.g., CAN, US,I certify that all expenses submitted are accurate and in accordance with McGill University policy and will
not be used for income tax purposes. I certify that all expenses paid by McGill University or by any otherparty have been deducted. I agree to refund to McGill University any subsequent reimbursements fromother organizations for the expenses submitted.

_____________________________________ ____________________
Claimant’s Signature

DateVisitor Claimant Signature Form
Request for Expense Reimbursement
This form is to be used to obtain the signature of University visitors who have departed prior to their electronic
expense report being processed. Along with the original receipts, this form must be signed and attached to the official
printed expense report. Use of this form is not permitted for McGill employees.

PROF. PAUL YACHNIN
I, _____________________________________ , authorize _______________________________
to submit(print visitor’s name)(print person’s name)the following expenses on my behalf. Attached are my receipts for:Purpose related to the expenses: _________________________________________________
Expenses were incurred from: ________________________ to ________________________(DD-MM-YY)(DD-MM-YY)
Amount of original receipt(s) attached: CAD$______________ USD$______________

Other ______________

Estimated expense(s) to be incurred following departure: CAD$ ___________ USD$__________ Other__________(state nature: i.e. taxi, meal) _________________________________________________________

Total estimated request for reimbursement in CAD$______________________________To be completed by Requestor at time of expense report submission
True value of total estimated request for reimbursement: CAD$ ___________________
Claimant’s Mailing Address: (provide complete address)
Address: _____________________________________________________________________________
City: ________________________________

State/Province: ______________________________

Postal/Zip Code: _______________________Country: ____________________________________

Reimbursement to be issued in (choose one): CAD ______USD ______

Other (specify) ________________(All reimbursements in “other” currencies will be made by wire transfer. The following banking information is required to ensure
successful transmission.)

IBAN #: ___________________________________________________________
Bank SWIFT/ABA RT# (if any):_________________________________________
Bank Name: ________________________________________________________
Bank Address: ____________________________________________________________________________________________________________
Beneficiary Bank Account Number: ______________________________________Name of Bank Account Holder: _________________________________________
I certify that all expenses submitted are accurate and in accordance with University policy and will not be used for income tax
purposes. I certify that all expenses paid by the University or by any other party have been deducted. I agree to refund to the
University any subsequent reimbursements from other organizations for the expenses submitted.
_________________________________________________________

Claimant’s Signature

Date

Revised 2009-02-09