| A | B | C | D | E | F | G | H | I | |
|---|---|---|---|---|---|---|---|---|---|
1 |  | CKS Expense Claim | Canoe Kayak Saskatchewan 1870 Lorne Street, Regina SK S4P 2L7 Email: ed@canoekayaksask.ca Phone: 1-306-975-7002 | Updated: Jan 2024 | |||||
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3 | Payable to: | Date of Claim: | |||||||
4 | Address: (Street, City/Town, Province, Postal Code) | ||||||||
5 | |||||||||
6 | Email address (for etransfers): | ||||||||
7 | |||||||||
8 | Reason for Expense: | ||||||||
9 | For Office Use only | ||||||||
10 | Air Transport | Date | Description | Pretax Total | GST | PST | Total | GST Claim | Ttl. w/o GST |
11 | (Receipts Required) | $ - | $ - | $ - | |||||
12 | $ - | $ - | $ - | ||||||
13 | Sub - Total | $ - | $ - | $ - | $ - | $ - | $ - | ||
14 | Ground Transport | Date | Description | Pretax Total | GST | PST | Total | GST Claim | Ttl. w/o GST |
15 | Taxi, Shuttle, Car Rental, Train, Etc. | $ - | $ - | $ - | |||||
16 | $ - | $ - | $ - | ||||||
17 | Sub - Total | $ - | $ - | $ - | $ - | $ - | $ - | ||
18 | Accomodation | Date(s) | Accomodation Name | Cost | GST | PST | Total | GST Claim | Ttl. w/o GST |
19 | Receipts Required for Hotel-like accomodation. For non-hotel stays, claim $50 | $ - | $ - | $ - | |||||
20 | $ - | $ - | $ - | ||||||
21 | $ - | $ - | $ - | ||||||
22 | Sub - Total | $ - | $ - | $ - | $ - | $ - | $ - | ||
23 | Mileage - Regular Travel | Date | Trip Description ($.55/km) | Km Driven | Total | ||||
24 | Travel with personal vehicle. Gas receipts not required. | $ - | |||||||
25 | $ - | ||||||||
26 | $ - | ||||||||
27 | Sub - Total | $ - | |||||||
28 | Mileage - Regular Travel - North | Date | Trip Description ($.59/km) | Km Driven | Total | ||||
29 | Travel above 54th parallel (see Map). Gas receipts not required. | $ - | |||||||
30 | $ - | ||||||||
31 | $ - | ||||||||
32 | Sub - Total | $ - | |||||||
33 | Mileage - Trailer/Hauling | Date | Trip Description ($.63/km) | Km Driven | Total | ||||
34 | Rate for vehicle hauling trailer with equipment Gas Receipts not required | $ - | |||||||
35 | $ - | ||||||||
36 | $ - | ||||||||
37 | Sub - Total | $ - | |||||||
38 | Mileage - Trailer/Hauling - North | Date | Trip Description ($.66/km) | Km Driven | Total | ||||
39 | Hauling Trailer above 54th parallel (see Map) Gas Receipts not required | $ - | |||||||
40 | $ - | ||||||||
41 | $ - | ||||||||
42 | Sub - Total | $ - | |||||||
43 | Meals/Per Diem | Date(s) | # of Meals | Meal Type | Total | ||||
44 | For use when meals aren't provided or you are traveling/away during regular meal times, etc. No receipts required | Breakfast | $ 11.00 | $ - | |||||
45 | Lunch | $ 16.00 | $ - | ||||||
46 | Dinner | $ 24.00 | $ - | ||||||
47 | Sub - Total | $ - | |||||||
48 | Other | Date | Description | Pre GST/PST Total | GST | PST | Total | GST Claim | Ttl. w/o GST |
49 | Please attach receipts & clearly describe expenses | $ - | $ - | $ - | |||||
50 | $ - | $ - | $ - | ||||||
51 | $ - | $ - | $ - | ||||||
52 | $ - | $ - | $ - | ||||||
53 | Sub-Total | $ - | $ - | $ - | $ - | $ - | $ - | ||
54 | Notes: | Totals | $ - | $ - | $ - | $ - | $ - | $ - | |
55 | Claim Total | $ - | Total will autocalculate | ||||||
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58 | |||||||||
59 | Have you attached all required receipts? | Yes | No | ||||||
60 | Do you wish to donate a portion of your reimbursement? -- If yes, please complete the "Donation Form" Tab | Yes | No | ||||||
61 | Did you share expenses with another individual? -- If yes, please complete "Shared Expenses" Tab | Yes | No | ||||||
62 | Attestation: | ||||||||
63 | By typing or signing my name below, I certify that all expenses incurred are related to Canoe Kayak Saskatchewan business, that none have been claimed from other organizations and that they comply with Canoe Kayak Saskatchewan travel expense guidelines. | ||||||||
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66 | _______________________________________________________ | ____________________________________________________________ | |||||||
67 | Signature of Claimant | CKS Approval | |||||||