INVOICE ALL FORMS MUST BE TYPED AND NOT HAND WRITTEN. THEY MUST ALSO BE COMPLETED IN FULL. FAILURE TO DO THIS WILL RESULT IN PAYMENT DELAYS OR NON PAYMENT Invoice Number Title (completed by LETB) First Name IN Invoice Date / / FULL Middle name XXRHOLLAND PO Number IN FULL FAO Surname Code Address Line 1 Address Line 2 Address Line 3 Town/City Post Code Invoice To: Health Education England T73 – East of England LETB T73 Payables F485 Phoenix House Topcliffe Lane Tingley Wakefield WF3 1WE BANK NOTE: PLEASE ENSURE DETAILS ARE ENTERED. FAILURE TO ENTER THESE DETAILS WILL RESULT IN PAYMENT DELAYS. Total Value of the Claim £ Please fill in the breakdown of the claim on the following page Details of the claim Travel Expenses
INVOICE ALL FORMS MUST BE TYPED AND NOT HAND WRITTEN. THEY MUST ALSO BE COMPLETED IN FULL. FAILURE TO DO THIS WILL RESULT IN PAYMENT DELAYS OR NON PAYMENT Title Invoice Number (completed by LETB) First Name IN FULL Invoice Date / / Middle name IN FULL PO Number XXRHOLLAND Surname FAO Address Line 1 Code Address Line 2 Address Line 3 Town/City Post Code Invoice To: Health Education England – T73 East of England LETB T73 Payables F485 Phoenix House Topcliffe Lane Tingley Wakefield WF3 1WE NOTE: PLEASE ENSURE BANK DETAILS ARE ENTERED. FAILURE TO ENTER THESE DETAILS WILL RESULT IN PAYMENT DELAYS. Total Value of the Claim £ Please fill in the breakdown of the claim on the following page Details of the claim Travel Expenses
general_expenses_claim_form_2.docx