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Mileage Claim Form Guide

This document is a mileage claim form for a business to claim fuel costs. It includes fields to enter the client name, employee name, vehicle details, fuel type, engine size and applicable fuel rates. There are also tables to claim mileage amounts per trip with totals, as well as year-to-date mileage amounts. The form allows claiming mileage costs at different rates depending on the total yearly mileage.

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Khin C
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201 views13 pages

Mileage Claim Form Guide

This document is a mileage claim form for a business to claim fuel costs. It includes fields to enter the client name, employee name, vehicle details, fuel type, engine size and applicable fuel rates. There are also tables to claim mileage amounts per trip with totals, as well as year-to-date mileage amounts. The form allows claiming mileage costs at different rates depending on the total yearly mileage.

Uploaded by

Khin C
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
You are on page 1/ 13

Client Name: [enter business / company name here] PETROL DIESEL

<1400 CC 0.15 <1600 CC 0.12


Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
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£ - £ - £ -
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£ - £ - £ -
£ - £ - £ -
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£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
Client Name: [enter business / company name here] PETROL DIESEL
<1400 CC 0.15 <1600 CC 0.12
Employee Name: [enter name of person claiming here] 1401 - 2000 CC 0.17 1601 - 2000 CC 0.14
>2000 CC 0.25 >2000 CC 0.18
Vehicle: [enter vehicle make and model here]
Fuel Type: [enter PETROL or DIESEL here] MILEAGE RATE 0.45
Engine CC: [enter engine cc here] FUEL RATE [enter applicable rate according to engine size]

Mileage rates:
MILEAGE CLAIM FORM 0.45 first 10,000 miles
TOTAL 0.25 any miles > 10,000
DATE DETAILS OF TRIP MILES £ VAT NET
£ - £ - £ - YEAR TO DATE
£ - £ - £ -
£ - £ - £ - Miles B/F
£ - £ - £ -
£ - £ - £ - Miles this month 0
£ - £ - £ -
£ - £ - £ - Miles C/F 0
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
£ - £ - £ -
0 £ - £ - £ -
MILEAGE CLAIM FOR YEAR ENDED [enter accounting period end date]

[enter name of person claiming here] of [enter business / company name here]

Total Business Miles Travelled during the year 0

0 miles @ 0.45 0.00


0 miles @ 0.25 0.00

TOTAL DUE 0.00

TOTAL PAID 0.00

Amount overpaid / (underpaid) 0.00

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