xls - ANU - COLLEGE OF BUSINESS _ ECONOMICS

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					Page 1 of 4                                                                HR15                                                                       4/23/2010


                                                                                                                         Human Resources, Building 10a
                                                                                                                     Human Resources Website
                                                                                                                              Enquiries: (02) 6125 3346
                                                                                                                              Facsimile: (02) 6125 5011


                                                                                                               University ID: u



               Application for Approval to use a Private Vehicle on Official
                                  University Business
                                       Section 1 - MUST BE COMPLETED PRIOR TO TRAVEL

    Family Name                                                                       Given Name

    Dept / Unit        College of Business and Economics

    School / Div

    Position No                                                                                                      Phone

      1       Application is made for approval to use my private vehicle on official University business as follows:
              (For staff only reference:
              http://info.anu.edu.au/Policies/_CFO_DFBS/Policies/Private_Vehicles_on_Uni_Business.asp

              The purpose and brief details of the journey (including carriage of passengers and/or goods) are




              My reasons for the use of a private vehicle instead of University or public transport are:




      2       I certify that I hold:

                     - a valid licence to drive the vehicle
                     - a comprehensive insurance of the vehicle

      3       In the event of approval, I hereby:

                     - indemnify The Australian National University against all liability which might arise out of the use of my private vehicle on the
                       approved official University business journey described in paragraph 1 above; and

                     - agree to accept the basis of reimbursement determined by the approving authority of the University.


    Note: Non-staff claims (student or visitors) should be limited to fuel expenses only and processed through the "Accounts Payable" system

    Signature of Applicant                                                                                                    D   D   M   M   Y   Y    Y   Y




    APPROVAL

    Approved / not approved and I determine that the basis of reimbursement for the above journey will be as follows:
      Refer to:     http://info.anu.edu.au/Policies/_DHR/Procedures/Travel_Allowances.asp

    Applicant to elect the method of reimbursement (please circle applicable method):
      (1) No Reimbursement sought;
      (2) Reimbursement of fuel costs only upon production of receipts; or
      (3) Cents per km Motor Vehicle Allowance. (NB: This option only available to ANU staff members and
      Section 2 must be completed)
    Signature of Approving Authority (in accordance with Delegation 4.13)

                                                                                  D    D   M    M   Y      Y     Y   Y




    School/Dept/Section          Georgia Foster               College Office, CBE

    University ID                u 3 2 8 7 5 2 9
Page 2 of 4                                                                     HR15                                                                   4/23/2010




                                                                                                             University ID:       U



                                          Payroll Instruction
                                 Cents per km Motor Vehicle Allowance
                                                            (Pay Codes 181,182 & 183)
                            Section 2 - TO BE COMPLETED UPON RETURN (where applicable)

        The following sections are only applicable to staff claims
         - Please attach supporting documentation as required.
         - Payment to be made in accordance with the            Travel Procedures

    PAYEE DETAILS



    Family Name                                                                            Given Name

    TRIP DETAILS

    From (location):



    To (location):



    Ordinary Car -                     Rotary Engine Car                   Rate per             Km                      Allowance                 Process using
    Engine Capacity                    Engine Capacity                     km (A)               Travelled (B)           Payable (A x B)           Pay Code

        1600cc (1.6 L or less)             800cc (0.8 L or less)           $ 0.63                                       $             -                181

        1601cc - 2600cc                    801cc - 1300cc                  $ 0.74                                       $             -                182
        (1.601 L - 2.6 L)                  (0.801 L - 1.3 L)

        2601cc (2.601 L and over)          1301cc (1.301 L and over)       $ 0.75                                       $             -                183



    Override Charge to Account                              A      S   S    D    D     D    S    S   G   G      A   A    A    A   S




    AUTHORITY


    For information on Delegations, see:             http://info.anu.edu.au/OVC/Delegations/


    Georgia Foster                                                                         Staff 1
    Name of Delegate                                                                       Profile (e.g. Head of Budget Unit, Admin Manager, Staff, etc.)

    Dept / Unit        College of Business and Economics
    School / Div       College Office
                                                                                                         D      D   M    M    Y   Y       Y   Y



                       Signature of Delegate                                                             Date

  Once the second page has been completed and signed-off it should be sent to HR for processing

                                                                       OFFICE USE ONLY
                                                                                                               Human Resources, Building 10a        Page Setup
                                                                                          http://info.anu.edu.au/policies/forms/human_resources/    Important - see pic to right
                                                                                                                      Enquiries: (02) 6125 3346
                                                                                                                                                    Font Specs:
                                                                                                                      Facsimile: (02) 6125 5011
                                                                                                                                                    Arial, 8pt
                                                                                                                                                    (Heading approx 18 pt)
                                                                                                     University ID:

                                                       Name of Form                                                                                 Row Heights:
                                                                                                                                                    spacer rows - 6
* lots and lots of notes that require a merge and word wrap lots and lots of notes that require a merge and word wrap lots and lots of notes that   form rows - 15
require a merge and word wrap lots and lots of notes that require a merge and word wrap                                                             notes rows - 12
* next point
* next point                                                                                                                                        Mast Head:
* next point                                                                                                                                        - Check/update phone and fax
                                                                                                                                                    numbers etc

                                                                                                                                                    Header:
                                                                                                                                                    - View > Header and Footer
SEGMENT ONE                                                                                                                                         - Update form number
                                                                                                                                                    - Page & date are auto

                                                                                                                                                    Notes:
                                                                                                                                                    - Don't change column widths
                                                                                                                                                    - Leave the border around inside
                                                                                                                                                    form blank (except where there is
                                                                                                                                                    a segment marker as illustrated)
                                                                                                                                                    - Only merge form boxes once
                                                                                                                                                    finished form
                                                                                                                                                    - To 'unmerge' cells select merged
                                                                                                                                                    area and go Format > Cells >
                                                                                                                                                    Alignment > uncheck Merge Cells
Page 4 of4                                                                          HR40                                                                               4/23/2010



                                                                                                                                     Human Resources, Building 10a
                                                                                                           http://info.anu.edu.au/policies/forms/human_resources/

                                                                                                                                            Enquiries: (02) 6125 3346
                                                                                                                                            Facsimile: (02) 6125 5011


                                                                                                                          University ID:

                                                         Application for Leave
      * Please refer to " Leave Provisions " — The Australian National University Enterprise Agreement 2003-2006 (Part 3, Section 4) for leave
      provisions. http://info.anu.edu.au/hr/Salaries_and_Conditions/Enterprise_Agreement/index.asp
      * Leave Credits can be checked using HORUS - http://horus.anu.edu.au/login.asp
      * Please write clearly in BLOCK LETTERS; please write — Y for Yes — N for No — in the appropriate boxes.
      * Please consult with your Case Manager if you are currently in receipt of Workers Compensation before applying for leave.

      Family Name:                                                                          Given Names/s:

      Dept/Unit:                                                                            School / Division:

      LEAVE TYPE                 (Please mark one category of leave; for more than one leave type, please complete separate forms for each type.)

      Annual Leave

      Personal Leave                              Is a medical certificate attached? (Y/N)

             Personal Leave Reason:               (please mark one of the boxes below if you have indicated Personal Leave above)

                  Sick                        Bereavement                        Cultural

                  Family Care                 Compassionate                      Birth, Adoption or Guardianship (Clause 38 of the ANU EA 03-06)

             Has absence arisen from an accident at work? (Y/N)

             If Yes, state details:

      Long Service Leave                               (Please mark one item)                    Full-time entitlement                         Half-time entitlement

      Leave Without Pay                                      State reason:

      Other Leave                                      Please specify*:

      * E.g. Study Leave, Maternity Leave, Primary Care-giver Leave, Jury and Witness Service, Defence Service Training

      PERIOD OF ABSENCE                       (Please specify the dates. If necessary to specify the times, please use 24-hour clock)

      First working day absent                    Time                                      Date of return to duty                         Time
       D      D    M     M   Y    Y   Y   Y        H     H     M   M                         D    D   M      M   Y    Y      Y   Y         H      H   M   M




                                                              Number of days                                         Number of hours

      CONTACT DETAILS WHILE ON LEAVE

      Address or                                                                                                                           Phone: ( )
      Location:

      Applicant                                                                                              D   D    M     M    Y     Y
      Signature:                                                                                 Date:                                         Phone (wk):

                                                     SUPERVISOR / DELEGATE TO COMPLETE
      (For information on Delegations see http://delegations.anu.edu.au)

      Are you reporting on the employee's behalf? (Y/N)                      If Yes, state reason/s

      Do you recommend the leave? (Y/N)                                      If No, state reason/s

      Is payment of salary to be stopped (Y/N)                               If Yes, state reason/s
      Supervisor                                                                                             D   D    M     M    Y     Y
      Signature:                                                                                 Date:                                         Phone (wk):
      Delegate                                                                                               D   D    M     M    Y     Y
      Signature:                                                                                 Date:                                         Phone (wk):
      Delegate
      Print Name:                                                                                Profile
                                                                                                            (e.g. Head of Budegt Unit, Admin Manager, Staff3)

				
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