Car Expenses Form by pnd13583


Car Expenses Form document sample

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These guidance notes are designed to assist you to submit accurate claims for reimbursement of expenses
necessarily incurred in the course of employment.

The frequency by which you are paid (Weekly or Monthly), Pay Division, Group Code, Pay Point and Pay
Number must be entered otherwise the form may be returned to you and payment may be delayed. The information
required to complete this can be found on the front of your current payslip.

You should ensure, before using your private vehicle on NHS business, that:

   You are properly insured to use the vehicle for that purpose. Motor Insurance must cover at least third party risk,
    including risk of injury to or death of passengers and damage to property. Your insurance certificate must specify
    cover for business use.
   A valid MOT Certificate is held, where appropriate.

All drivers are required to certify that they hold a current full driving licence.


   “Employee Details” at the top of the form should be completed in full and in BLOCK CAPITALS.
   “Home Address" should be the address at which you are normally resident throughout the working week.
   “Designation” and “Base” should be completed in all cases.


Please indicate your car user status: Regular (REG), Standard (STD), Public Transport (PTR), Lease (LC). The engine
size of the vehicle must also be completed.

   “Leased Cars Only”: Car registration and all mileage readings must be completed


The cost of excess travel may be reimbursed for a period of four years following a permanent change of base.
Payment is taxable and is calculated on the excess mileage travelled in the employee’s own car to the new base or,
where public transport is used, on the additional cost of travel to the new base, making full use of weekly or monthly
tickets and zonecards where appropriate. Leased car users are advised to contact the Car Leasing Section for advice
on the tax implications before making a claim. In the case of temporary moves advice should be sought from the
expenses department.


If you have changed your car since your last claim please attach a copy of the insurance policy for your new car to the

For change of car or user type a claim form with mileage and details up to the date of change should be submitted
along with a separate form showing mileage and details following the date of change.

Should you temporarily use another vehicle please annotate the vehicle cc against the mileage claimed for the second
vehicle. In the case of a second lease car or a replacement for a lease car please complete a separate claim.


Column 1:“DATE”: Please use one line per day where possible and one claim form per calendar month.

Column 2: “REASON FOR JOURNEY”: The detail in this column helps to determine the rate of reimbursement and
tax treatment for the type of journey you are making. Each journey should be classified as one of the following:
B = Business ; S = Study Leave; C = Call Out; O = Overtime; PH = Public Holiday
Column 3: “DETAILS OF JOURNEY”: Full details of the business journey should be completed. Each journey must
include a start point and an end point. It is not sufficient to write the name of the place visited without detailing the start

point and the return destination. Staff, such as District Nurses, who make several visits within an area do not need to
list every street visited - it is sufficient to quote the area visited. If you have not travelled by car please state the method
of travel.

Column 4: “HOME TO PLACE VISITED”: enter mileage where the business journey has a home component.
i.e.Home to Place(s) Visited to Home; Home to Place(s) Visited to Base; Base to Place(s) Visited to Home

Where there is a “home” component to any business journey you must additionally complete columns 5 and 6.

Column 5: “BASE TO PLACE VISITED”: This Column must be completed in all circumstances when HOME TO
PLACE VISITED (Column 4) is completed. Details of this hypothetical journey are required as you are only entitled to
reimbursement of the lesser of the actual mileage travelled (home to place visited return) or the return mileage for
base to place visited. Where more than one location is visited the hypothetical mileage entered should be from base to
 st          st            nd
1 location, 1 location to 2 location etc to base.

The “lesser of” Column 4 or Column 5 must now be entered in Column 6 - Business Mileage.

Column 6: “BUSINESS MILEAGE”: Enter the mileage associated with the business journey. Where the business
journey neither starts nor ends at home then columns 4 and 5 can be ignored.

Column 7: “PUBLIC TRANSPORT MILEAGE”: This column should be used to record mileage incurred during study
leave or while travelling to your normal workplace to work an overtime shift on a rostered off duty day (but only where
you are entitled to receive an overtime payment). This column is not applicable for leased car users.

Column 8: “PASSENGER MILEAGE CLAIMED”: Where you have carried official passengers the total miles involved
should be entered in this Column. E.g. if you carry 3 passengers on a return journey of 40 miles, 120 should be
entered. Names of passengers carried should also be annotated. This column is not applicable for lease car users
or for the carrying of patients.

Columns 9,10,11 and 12: “EXPENSES”:

   “TIME OF DEPARTURE/RETURN”: These Columns need only be completed in the following circumstances:-
    - If you are claiming subsistence of any kind.
    - If your journey is outwith your normal working hours e.g. Call Out or Overtime.
   “DETAILS OF SUBSISTENCE OR OTHER EXPENSES CLAIMED”: This Column should be used to show any
    other type of business expense which you have incurred – i.e. subsistence – agreed GWC rates will apply -
    receipts must be provided for overnight accommodation claims; claims for reimbursement of public transport
    fares and parking costs must be supported by receipts; telephone rental will be reimbursed only to authorised
    users on production of the original telephone account. Where authority is held for reimbursement of business calls
    all such calls should be highlighted on the account.

TOTALS – Boxes at the foot of columns 6, 7, 8 and 12 must be totalled.

All Claims should be short-ruled after the last item claimed on the form. “Short ruled” means that a single diagonal line
should be added to the form, starting at the extreme right of the first blank line below the last entry and extending to the
bottom line on the claim form.

7. EMPLOYEE CERTIFICATION – Please ensure that you sign your claim and pass it to your Certifying Officer for

8. AUTHORISATION – It is the responsibility of the authorising officer to ensure that the form is a true representation
of expenses necessarily incurred in the course of the claimant’s job. The authorising officer should forward the claim to
the Expenses/Payroll Department to be processed.

Forms should be submitted on a monthly basis covering a full calendar month’s expenses and
should be forwarded to the Expenses/Payroll Department no later than the published deadline
(generally the 5th working day of the following month) in order to guarantee payment with that
month’s salary.


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