Sundry Expenses Claim Form

							                                                                                                Employee Name:                                                                     Employee Number:


                                                                                                Home address:


                                                                                                Location of temporary workplace/site address:

                                                                                                                                                                        Car        Motorcycle          Bicycle
                Expenses Claim Form                                                             Date:                                      Method of Transport:


 1                               2                                         3                                      4                         5               6             7               8                9                        10                  11

                                                                  Miles Travelled                       Subsistence Expenses                                          Incidental
                                                                                                                                       Other Travel     Overnight                   Tools, Safety
                Description of Business Journey                                                                                                                        Expense                      Sundry Expenses
                                                                                                                                          Costs       Accommodation                 Equipment etc
Date                                                                                                                                                                  Allowance                                       Description of Sundry Expenses   TOTAL
                         (From and To)                                         Amount Claimed                         Amount Claimed
                                                                                                Hours away from
                                                         Number of Miles             £                                   £5 or £10          £               £             £               £               £
                                                                                                 home location




                       Amount Claimed


                      OFFICE USE ONLY


                 Amount not authorised for payment



                          Amount Paid



       I DECLARE THAT THE ABOVE EXPENSES WERE INCURRED WHOLLY, EXCLUSIVELY AND NECESSARILY IN THE PERFORMANCE OF MY DUTIES AS AN
       EMPLOYEE OF SPRITE AND THAT I HAVE READ AND UNDERSTOOD SPRITE'S EXPENSES POLICY. I CONFIRM THAT THE EXPENSES I HAVE CLAIMED
       RELATE TO A TEMPORARY ASSIGNMENT THAT WILL LAST LESS THAN 24 MONTHS AT THIS LOCATION, AND I DO NOT INTEND THIS TO BE MY FINAL
       ASSIGNMENT THROUGH SPRITE. WHERE I HAVE CLAIMED SUBSISTENCE/MEAL ALLOWANCES AND NOT SUBMITTED RECEIPTS I CONFIRM I HAVE
       RETAINED ALL RECEIPTS MYSELF.                                                                                                                                      SIGNED