Appendix 4 - Sample Claim Form Promoter Name: Promoter Identification № : Project Expenditure Details Supplier VAT Invoice Eligible Amount Invoice № Name Total € VAT€ Registered VAT № Date € Y/N Total Eligible € Payment Calculation Theme: Total Due: Grant Rate: Total Eligible: Sub-theme: (Total Eligible x Grant rate) Tax Reference Number: Date of Check: Tax Clearance Access Number: Promoter Signature: Date:
Appendix 4 - Sample Claim Form Promoter Name: Promoter Identification № : Project Expenditure Details Invoice № Supplier Name Invoice Date Total € VAT€ Eligible Amount € VAT Registered Y/N VAT № Total Eligible € Payment Calculation Theme: Sub-theme: Grant Rate: Total Eligible: Total Due: (Total Eligible x Grant rate) Tax Reference Number: Tax Clearance Access Number: Date of Check: Promoter Signature: Date: