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[null,"Kilometer godtgjørelse",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ansatt nummer"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fødselsnummer (11 siffer)"]
[null,"Navn:",null,null,null,null,null,null,null,null,null,"Tlf. privat:"]
[null,"Adresse:",null,null,null,null,null,null,null,null,null,"Tlf. arbeid:",null,null,null,null,"Skattekommune"]
[null,"Postnr:",null,null,null,null,null,null,null,null,null,"Mailadresse"]
[null,null,"Sted",null,null,null,null,null,null,null,null,"Avdeling:"]
[null,null,"Reisens formål:"]
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[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Beløpet overføres til konto nr:"]
[null,"1. Reiseutgifter"]
[null,"Kun utgifter iflg.vedlagte originalbilag refunderes"]
[null,"Unntatt er bompenger (spesifiser hvilke(n) bomstasjon(er) som er",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Er du medlem av Norges Røde Kors?"]
[null,"passert og beløp pr. passering"]
[null,"Billetter betalt av organisasjonen skal også legges ved,",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ja:",null,null,"Nei:"]
[null,"men beløpet skal ikke føres"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Lønnart",null,"Er du lønnsmotaker i Norges Røde Kors i år?"]
[null,"Sum utlegg, bilag legges ved skjema ved innsendelse",null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B41=7140,4000,IF(B41=7141,4002,IF(B41=7143,4004,\"0000\")))","v":"0000"}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ja:",null,null,"Nei:"]
[null,"2. Kilometergodtgjørelse"]
[null,"Sum totalt antall km. Overføres fra side 2",null,null,null,null,null,null,null,{"$f":"'Km spesifikasjon'!H40","v":0},"á kr",4.0999999999999996,"Kr:",{"$f":"J25*L25","v":0},4200]
[null,"Passasjer(er) totalt ant.km. Overføres fra side 2",null,null,null,null,null,null,null,{"$f":"'Km spesifikasjon'!J40","v":0},"á kr",1,"Kr:",{"$f":"J26*L26","v":0},4206]
[null,"Kjøring med tilhenger. Overføres fra side 2",null,null,null,null,null,null,null,{"$f":"'Km spesifikasjon'!I40","v":0},"á kr",1,"Kr:",{"$f":"J27*L27","v":0},4208]
[]
[null,"Sum til utbetaling",null,null,null,null,null,null,null,null,null,null,null,{"$f":"N22+N25+N26+N27","v":0}]
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[]
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[null,"Dato",null,null,null,null,null,"Egenhendig underskrift"]
[]
[null,"Fylles ut av organisasjonen",null,null,null,null,null,null,null,null,null,null,null,null,"Tekst"]
[]
[null,"Vedr.kostnadsføring -"]
[null,"alle 3 rubrikker må fylles ut!"]
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[null,"Konto (for reiseutgifter 4 siffer):"]
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[null,"Kostnadssted:",null,null,null,null,null,null,null,null,null,null,null,null,"Attestasjon"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"Signatur:"]
[]
[null,"Aktivitet:",null,null,null,null,null,null,null,null,null,null,"Navn i blokkbokstaver:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Anvisning"]

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[null,"Kjørt fra",null,null,"Kjørt til"]
[null,"Dato","Sted",null,"Dato","Sted",null,"Antall km","Antall km med tilhenger","Antall km med passasjer","Navn på passasjerer","Reisens formål"]
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[null,"Sum totalt antall km overføres til side 1:",null,null,null,null,null,{"$f":"SUM(H3:H39)","v":0},{"$f":"SUM(I3:I39)","v":0},{"$f":"SUM(J3:J39)","v":0}]