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cashout form v0.1
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* Indicates required question
User
Choose
ta
mh
hh
ah
mhj
Transaction Date
*
E.g. the date on the receipt
MM
/
DD
/
YYYY
Payee
*
E.g. BP, Tesco, Rodica, Adina
Your answer
Description
*
E.g. petrol, food, cleaning, etc
Your answer
Payment method
*
Choose
Cash
Debit card
Amex
Other credit card
Amount (£)
*
Your answer
Receipt
*
Do you have a receipt for this transaction?
Yes - please submit a scan
No
Submit
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