ADMIN FORM - Mileage Form

Please complete at the end of each shift/event that you incur mileage costs

Name Name First Last
Vehicle Registration Number
Date Date / MM / DD YYYY
Name of Service User (if reimbursable to the client)
Mileage at start of shift
Mileage at end of shift
Total miles used on shift
Details of the mileage used
(Please include start and end location of each trip, and purpose of the trip)
Total to be reimbursed
(In tax year from 1st April to 31st March you can claim at the rate of 40p a mile for the first 10,000 miles and thereafter at 25p a mile) £ Pounds . Pence
Name of Supervisor Name of Supervisor First Last
Agreed and sent to Finance Officer for reimbursement

Agreed and sent to Finance Officer for reimbursement Yes No