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Expense Form
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Employee Name
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Company Name
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Date
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Date Week Ending
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Shift Allowance ClaimsMileage Claims
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Type of ClaimAmount ClaimableClaimed?DatePostcode FromPostcode ToMiles
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5 Hour Shift Allowance£5
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Above 5 Hour Shift Allowance£10
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15 Hour Shift Allowance£25
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Personal Incidental Expenses£10 Per Nighshift
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Washing of Work Wear£10 per Week (Max)
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Home Office£6 per week
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Overnight Allowance (Digs)£25 per night
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Total Miles0
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Receipted Claims£0.25pm/£0.45pm£0.45
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Type of ClaimAmountClaimed?Total (£)£0.00
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Tolls/Bridges/ULEZ
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Accommodation
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EquipmentDeclaration - All submitted expenses have been incurred wholly, exclusively and necessary in conjunction with performing my duties. I understand that valid receipts must be obtained and retained to support my expense claims. I understand that my receipts may be required for proof of claim.
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Stationary & Postage
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Training
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Car Hire/Equipment Hire
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Purchase of PPE
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Books & JournalsSigned
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Parking
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Other
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