Sheet 1: Expenses Claim Form

	
	
	
	
	
	
	
	
	
	
	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Travel and Expenses Claim Form
		
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Claimant Name: 
		


		


		
School:
		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Bank Sort Code:
		


		


		


		
(to be completed if first claim)
		


		


		


		


		


		


		


		


		


	
	

		
Bank Acct Number:
		


		


		


		
(to be completed if first claim)
		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Receipt Number
		
Date
		
Total Mileage Claimed (miles)
		
Travel fares e.g. train tickets, parking permits
		
Educational Supplies (£) (4010)
		
Overnight Stay Meal Allowance (£25 per night)
		
Other (£)                   
		
Supplier
		
Description of expenditure
		
Pupil Related? (Y/N)
		
VAT (£)
		
Mileage rate per mile
		
Total Receipt
		
BUDGET
	
	

		
EXAMPLE
		
12/01/2016
		
100
		


		


		


		


		
ASDA
		
Petrol to Portsmouth for training course
		
N
		
£0.00
		
£0.45
		
£45.00
		
MSTA
	
	

		
EXAMPLE
		
12/01/2016
		


		


		


		
£25.00
		


		
ASDA
		
Overnight stay 12/1/16 
		
N
		
£0.00
		


		
£25.00
		
MSTA
	
	

		
1
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
2
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
3
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
4
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
5
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
6
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
7
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
8
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
9
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
10
		


		


		


		


		


		


		


		


		


		


		


		
 £-   
		


	
	

		
By signing this form, you agree that all claims above were made in the interests of the Academy
		


		


		


		


		


		


		


		
Total claim:
		


		
 £-   
		


	
	

		
Claimed by:
		


		


		


		
Authorised by:
		


		


		


		


		


		


		


		


		


	
	

		
Signature:
		


		


		


		
Signature:
		


		


		


		


		


		


		


		


		


	
	

		
Date:
		


		


		


		
Date:
		


		


		


		


		


		


		


		


		


	
	

		


		


		


		


		


		


		


		


		


		


		


		


		


		


	
	

		
Please remember to attach ALL receipts to this form, including a VAT receipt where necessary