1
2
3
Date
From
Το
Time
Place
Time
Place
4 Journey Details
a. Reason for journey and official destination b. Name(s) of car passenger's) for whom supplement is claimed plicable
c. Overnight accommodatio.. address if night
subsistence allowance is claimed
5 Mode and class of
Transport Used
(For rail travel please state whether warran
t used. If not give ticket number, date and office of issue)
17 Oct 1436 TAX
12 Nov 1430
from official
Taxi from official Kindl
lunk al
Waldest Hotel & FG
Kund at Chinese
Chinese Emdary to few
Taxı
Taxi
Travel by Private Car
Amounts Claimed
8
Mileage
at standard
rate
7
9 Mileage Passenger Travelling
rate
at Public mileage expenses Transport
£ p
10 Subsistence Allowances
11 Other expenses
£ р
£ P
3150
3:20.
1
1
Notes 1. Please use the 24 hour system (where 1 pm is 13.00)
2. This claim must be closed with a diagonal line before it is submitted for approval
3. Supporting vouchers should be attached for incidental expenses.
4. Details of the travel and subsistence rules, and current rates, are shown in the
Pay and Conditions of Service Code.
Total standard mileage this claim
Cumulative standard mileage since 1 April last brought forward from previous claim Cumulative standard mileage carried forward to next claim
Sub totals
Claim total
8190
less imprest (if any)
Net amount *claimed/due to the Department
•
Delete pe appropriate