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["Antrag auf Auslagenerstattung"]
{"$rows_empty":11}
["(Vorname + Name)"]
[]
["(Strasse + Hausnummer)"]
[]
["(Postleitzahl + Wohnort)"]
[]
["(Telefon/Fax - Nummer; Email Adresse für Rückfragen)"]
[]
["Aufstellung der Auslagen:"]
[]
["Nr.:",null,"Datum",{"$nulls":3},"Verwendungszweck",{"$nulls":7},"Betrag in €"]
{"$rows_empty":11}
[{"$nulls":6},"Gesamtbetrag:",{"$nulls":7},""]
[]
["Die Originalbelege sind als Anlage/n beigefügt."]
[]
[]
[]
["(Datum)",{"$nulls":9},"(Unterschrift)"]