Contractor Name

Contractor Name

Week Ending

2016

Mileage Log

(please use postcode where possible)

Date

From

To

Miles

Return

Add +

The above travel expenses have been incurred wholly in conjunction with performing my duties. I understand that valid receipts are required to process my expenses.

Total Miles

0.45ppm / 0.25ppm

Total £'s

Non Receipted Claims

Total £'s

Quantity

Breakfast (pre 06:00 start only)

£5.00

P/Day

Lunch

£5.00

P/Day

Evening Meal (post 18:00 finish)

£5.00

P/Day

Washing Work Wear

£5.00

P/Week

Personal Incident Expense

£5.00

P/Overnight

Home Office

£4.00

P/Week

Overnight

£26.20

P/Night

Total

Receipts Claims

(receipts required)

Total £'s

Quantity

Telephone Pre-pay (max £10.00 P/Week)

Accommodation

Equipment / Stationary / Postage

Training

Car / Equipment Hire

Purchase of Work Wear

Parking

Other

Total

Declaration

Signed

Print

Date

2016