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Mountain Views Supervisory Union
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Mileage Reimbursement Form
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School/Location:Employee's Name
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Date:
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RETURN FORM TO ACCOUNTS PAYABLE DEPARTMENT
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DATEDeparture LocationArrival LocationPurposeMilesComments
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TOTAL miles 0.00 total miles x .700 $ -
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Account #
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EMPLOYEE'S SIGNATURE _________________________________
SUPERVISOR'S APPROVAL _________________ (Initials)
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1. This mileage rate is effective for all reimbursable travel on or after January 1, 2025 until further notice.
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2. The Trip Cost Chart lists the standard one-way trip to local destinations. Distance is measured from either your home address or your work address, whichever is closest.
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3. MILES claimed for each line may be the total for the DATE or multiple date entries may be made.
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4. MILEAGE paid for grants is that which is specified within the grant documentation.
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5. Mileage reimbursement requests MUST be submitted at least every quarter within 30 days following the end of the quarter.
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6. Year end submissions must be done by the last day of school
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form revised 01/09/25
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