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[]
["Heilpädagogische Schule Oberaargau"]
["Schorenstrasse 19"]
["4900 Langenthal"]
[]
["062 558 36 00"]
["finanzen@hps-oberaargau.ch"]
[]
["Rückerstattung der Transportkosten für Eltern"]
[]
[]
[null,"Kind oder Jugendliche/r"]
[]
[null,"Name/Vorname",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Geb. Datum"]
[]
[null,"Gesetzl. Vertretung des Kindes oder der/des Jugendlichen"]
[]
[null,"Name/Vorname"]
[]
[null,"Strasse, PLZ, Ort"]
[]
[null,"Bank- / Postverbindung",null,null,null,null,null,null,null,null,null,null,null,"Postkonto Nr.",null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,null,"-"]
[]
[null,"IBAN",null,null,null,null,"C","H"]
[]
[]
[]
[null,"Öffentliche Verkehrsmittel"]
[null,"Reisestrecke",null,null,null,null,null,"Reisezweck",null,null,null,null,null,"Zeitraum",null,null,null,null,null,"Art der Billette/",null,null,null,null,null,"Anzahl",null,null,null,"Billet-",null,null,"Betrag"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Abonnemente",null,null,null,null,null,null,null,null,null,"Preis"]
[null,"von",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Z31*AD31","v":0}]
[null,"bis"]
[null,"von",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Z33*AD33","v":0}]
[null,"bis"]
[]
[null,"Bitte Kopie der Kaufquittung beilegen"]
[]
[]
[]
[null,"Privatfahrzeug"]
[null,"Reisestrecke",null,null,null,null,null,"Reisezweck",null,null,null,null,null,null,"Zeitraum",null,null,null,null,null,"Anzahl",null,null,null,"KM pro",null,null,null,"Ansatz",null,null,null,"Betrag"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fahrten",null,null,null,"Fahrt",null,null,null,"pro KM"]
[null,"von",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.7,null,null,null,{"$f":"U43*Y43*AC43","v":0}]
[null,"bis"]
[null,"von",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0.7,null,null,null,{"$f":"U45*Y45*AC45","v":0}]
[null,"bis"]
[]
[null,"Bitte Kopie der Belege beilegen",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Gesamttotal",null,null,null,null,{"$f":"AG31+AG33+AG43+AG45","v":0}]
[]
[]
[null,"Bemerkungen"]
[]
[]
[]
[null,"Ort/Datum",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Unterschrift"]