Expenses claim form - template.xlsx

	A	B	C	D	E	F	G	H	I	J
1	Expenses claim form
2	Name		Date	Department/Project
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5	About your motor vehicle (for mileage claims only)					Rate per mile (pence)
6	Type of vehicle (select from drop down)					Car	55	Only complete this section if this is your first claim or you have changed details:
7	Vehicle registration					Electric vehicle	55
8	Estimated CO2 per mile (g)					Bicycle	20		Bank:	As per payroll
9	Or to find and enter your model's exact CO2 per mile see bottom of page					Motor bike	24		Sort Code:
10						+ Passengers	5		Account no:
11	Mileage claim (please complete above first)
12	Nature of journey	Date	Transport (select from drop down)	Miles	Extra passengers		Rate per mile (p)	Total (£)	CO2 (kg)	Budget code
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21									Total claim	£0.00
22	Other travel claim e.g. train ticket
23	IMPORTANT: for hire vehicles please photograph start and finish fuel guage and send to finance
24	Nature of journey	Date	Transport (select drop down)			£ expense	Approx miles	CO2 gpm	CO2 (kg)	Budget code
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33									Total claim	£0.00
34	Other expenses e.g. accommodation
35	Nature of business		Date							Budget code
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42									Total claim	£0.00
43	To submit your claim
44	1. Email completed form to your manager/supervisor who will check and authorise payment.								Grand total	£0.00
45	2. Ensure receipts are attached with your email (scan paper receipts).								CO2 (kg)	0.00
46	3. By submitting you are certifying the claim is a correct record of official journeys in the vehicle stated, which was licensed and insured during the relevant period.
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48	For managers/supervisors
49	Ensure budget code has been entered. Claims without budget codes will not be processed.
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51	For sustainable travel advice & resources:		To calculate your model's exact CO2 per mile:
52	https://linktr.ee/gardenorganicsustainabletravel		1. Link here to find your model's exact (WTW) CO2 per km and enter below to convert to miles
53			2. Enter WTW CO2 per km (g) to convert:					=	0.0	CO2 per mile (g)
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