Name: 

Address: 

Apt, Street No, Street:

City:

Province:

Country:

Postal Code:

Telephone Number: 

Appeal Number:

Hearing Date (yyyy-mm-dd):

Hearing Location (City/Province): 

Departed Home Time:

Departed Home Date: 

Hearing Start Time: 

Hearing End Time: 

Arrived Back Home Date: 

Arrived Back Home Time: 

Private Vehicle

Total kilometres driven (return trip)

$ 

Parking, taxi, train, air, bus

$ 

(Original receipts, travel itineraries and boarding passes required.)
Airline tickets and train tickets must be arranged through the OCRT.

Photocopying Charges (original receipts are required)

$ 

Other Charges (please explain)

$ 

Meals (please specify)

No receipts are required.

Breakfast: 

$ 

Lunch: 

$ 

Dinner: 

$ 

Incidentals: 

$ 

Accommodation

All expenses for overnight accommodation must be pre-authorized by Financial Services.