Claim for Private Vehicle Travel

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					                                  Claim for Private Motor Vehicle Travel


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        $


                 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.