British Columbia Travel Affidavit Form

Transcript

CANADA BRITISH COLUMBIA PRINCE GEORGE TO WIT: TRAVEL AFFIDAVIT I,_____________________________ of Prince George, in the Province of British Columbia, make oath and say as follows: 1. That I have lost / not received (circle one) the receipt in connection with my Travel claim to University of Northern British Columbia re: merchant: __________________________________________________ for the amount of: ___________________________________________ for the purpose of: ___________________________________________. 2. That I have not been, nor will I be, reimbursed by any third party for the amount of the above noted claim. SWORN TO at Prince George, in the ) Province of British Columbia ) this ___ day of _____________ ) 201___ ) in the presence of ) ) ) ) _________________________ ) COMMISSIONER OF OATHS ___________________________ G:\Purchasing\Office\Miscellaneous\Blank Forms\Affadivit - Travel.doc