Travel Claim/Salary Repayment

Complete below to make a travel claim or salary repayment.

Travel Claim

Mileage Rates: Single $0.60/km 1 addt'l Passenger $0.62/km 2 addt'l Passengers $0.64/km. 3 or more addt'l Passengers $0.66/km Short trip (20 kms or less) $12.00
MM slash DD slash YYYY
Home Address(Required)
Travel Claim Details
Date
What meeting/conference/education
# of Kms
Km. rate
Meals
All other
TOTAL
 
Salary Repayment Claim Details
Dates
Shifts
# of hours
Hourly wage