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[null,"F.D.M.J.C. D'ALSACE\ncontact@fdmjc-alsace.fr",null,"Demande de remboursement\nFRAIS DE DÉPLACEMENTS - BÉNÉVOLE"]
[{"$nulls":6},"Mois concerné "]
[]
[null,"Nom ",null,"Prénom ",null,null,"Territoire "]
[]
[null,"DÉPLACEMENTS",{"$nulls":5},"N° de compte : 625100"]
[null,"DATE","DÉPART DE…","ARRIVÉE À…","NBR DE KM\nPARCOURUS","MOTIF DU DÉPLACEMENT"]
{"$rows_empty":21}
[{"$nulls":3},"Total (en km)",{"$f":"SUM(E8:E28)","v":0},null,"Total déplacements à rembourser (en €)",{"$f":"E29*0.5","v":0}]
[]
[null,"  FRAIS (TRAIN/PARKING/PÉAGE/AUTRES) avec factures",{"$nulls":5},"N° de compte : 625100/60…."]
[null,"DATE"]
[null,"MONTANT"]
[null,"MOTIF"]
[{"$nulls":6},"Total frais (train, etc) à rembourser (en €)  ",{"$f":"SUM(C33:H33)","v":0}]
[]
[null,"CONTROLE ET APPROBATION",{"$nulls":3},"TOTAL À REMBOURSER ",null,{"$f":"H29+H35","v":0}]
[null,"Référent territoire",null,"Coordinateur siège / direction :"]
[null,"Date :",null,"Date :",{"$nulls":4},"Je souhaite faire don de mes frais à la FDMJC (contre reçu fiscal)"]
[null,"Signature :",null,"Signature :",{"$nulls":4},"Je certifie que ma demande est sincère et conforme"]
[{"$nulls":5},"Date :",{"$f":"TODAY()","v":"2026-02-03"},"Signature :"]