Claim for Private Motor Vehicle Travel Name School Town Nature of Activity Date of Activity Venue Other attendees who travelled with you Kilometres are calculated from your school to the venue, not from your home. Private Car: kms @ c/km $ TOTAL $ Comments/Explanations Reimbursements may be shown on your group certificate Payment Method Cheque Payable to: [Cheque option for non staff only] Deposit to My Current Salary Account Signature of Claimant Date Signature of Principal Date Motor vehicle travel can only be reimbursed into your normal salary account. These amounts will be recorded onl your group certificate as an allowance. Claims should be made within 1 week of attendance at an approved event. Only one trvel claim per school will be reimbursed.