UNE Reimbursement or Refund Form

For UNE Staff, Students or Non-business Individuals

In order to establish or update to enable reimbursement/refund from the University, we require the following information:

You must complete the following form in full
To ensure the integrity of banking details, payments will not be made without this information being provided

Required fields are marked with an asterisk (*).

Applicant type

I am a: *

UNE Staff Member
UNE Current Student
Community Member

Bank account location

Where is your Bank Account location? *

In Australia
Outside of Australia

Personal contact details

Title

First Name *

Surname *

Address Line 1 *

Address Line 2

Address Line 3

City *

Post code / zip code *

Is your postal address the same as your residential address?

Address Line 1

Address Line 2

Address Line 3

City

Post Code / zip code

Phone number *

Remittance/payment email address *

Bank details

Account holders name *

Bank name *

UNE contact

UNE Staff name contact * Approval notification will be sent to the UNE staff member.

Privacy and Consent

The information provided on this application form is being collected to enable the University of New England to pay you a reimbursement. This information will be processed by the Financial Performance and Analytical Services. Information collected on this form will adhere to UNE’s Privacy Management Rule and Procedures. Please visit UNE's Privacy page for more information.

By submitting this form I declare that all information supplied is complete and accurate.