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Zephyr Meetup Reimbursement Request
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Please Print
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Name:
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Mailing Address:
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Phone:
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Email Address:
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Date of Global MeetupLocation of Global MeetupURL of Meetup PageTotal Cost (maximum $250 USD)
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Reimbursement will be made in US Dollars using conversion rate on date of wire transfer.
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Please allow 30 days from date of receipt for reimbursement.
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A copy of all receipts must be attached as one PDF file.
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Residents of the United States will be reimbursed by check to the Mailing Address stated above.
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Signature & Date
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Approved by Brett Preston on (Date)
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Wire Remittance Information Request *
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I hereby authorize Zephyr Project (Linux Foundation) to initiate wire payments to my account at the financial institution named below. Further, I agree not to hold Zephyr Project (Linux Foundation) responsible for any delay or loss of funds due to incorrect or incomplete information supplied by my financial institution or due to an error on the part of my financial institution in depositing funds to my account. This agreement will remain in effect until Zephyr Project (Linux Foundation) receives a written notice of cancellation from my financial institution, or until I submit a new wire payment form to Zephyr Project (Linux Foundation).
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NAME ON BANK ACCOUNT:
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ADDRESS ON BANK ACCOUNT:
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Your Bank Information:
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Beneficiary Bank Name:
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Beneficiary Bank Address:
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International Routing (SWIFT) Code:
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Your Account Number:
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Intermediary Bank Name (if applicable):
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 Intermediary Bank Address:
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Intermediary Bank ABA Routing Number:
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Signature:
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Printed Name:
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