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[null,"NORSK BRIDGEFORBUND"]
[null,"Sognsveien 75 A"]
[null,"0855  OSLO"]
[]
[]
[]
["                FORENKLET REISEREGNING"]
[]
["(BRUK KUN BLOKKBOKSTAVER)"]
["Reiseregningen må innleveres senest innen 14 dager etter kampdato. Betales ut 15. i hver mnd."]
[]
["Navn",{"$nulls":3},"Personnr. (11siffer)"]
["Adresse",{"$nulls":3},"Bankkontonr.:"]
["Poststed",{"$nulls":3},"Skattekommune"]
[]
["Turnering:",{"$nulls":4},"Runde/div.:"]
[]
["Deltakere:"]
[]
[]
[]
[]
["Reisen:"]
["Avreise","Ankomst","Rute",null,null,"Egen Bil"]
["Dato","Dato",{"$nulls":3},"Antall km à","Kr"]
["Klokke","Klokke",{"$nulls":3},"1,50 kr"]
[{"$nulls":6},0]
[{"$nulls":6},0]
[{"$nulls":6},0]
[{"$nulls":6},0]
[{"$nulls":5},"SUM KJØRING:",0]
[]
["Spesifikasjon av andre utlegg:"]
["Utgiftstype",{"$nulls":5},"Kr"]
{"$rows_empty":7}
[{"$nulls":5},"SUM ANDRE UTLEGG:",0]
[]
[{"$nulls":5},"TOTALT:",0]
[{"$nulls":5},"EGENANDEL:"]
[{"$nulls":5},"TIL UTBETALING:",0]
[]
["Dato:",null,"Utsteders underskrift:"]
[]
["Dato:",null,"Attestasjon:"]