2
From
3
To
Time
Place
Time
Place
Salisco Lichfield
Ist wc2
FOO
4 Journey Details
a. Reason for journey and official destination b. Name(s) of car passenger(s) for whom supplement is claimed if applicable
c. Overnight accommodation address if night
subsistence allowance is claimed
Return from official lunch
5 Mode and class of
Transport Used
(For rail travel please state whether warrant used. If not give ticket number, date and office of issue)
Такі
Travel by Private Car
Amounts Claimed
6
Mileage
at standard
rate
7
8
9
10 Mileage Passenger Travelling Subsistence at Public mileage expenses Allowances Transport rate
11 Other expenses
£ P
р
ε
P
350
I
|
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
3
3.50
Claim total 35
less imprest (if any)
Net amount "claimed/due to the Department
*
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