Novated Lease Expense Claim Form

Novated Lease Expense Claim Form

Submit an out-of-pocket expense for reimbursement
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Employer*
Vehicle Registration Number*

Payment Type*

Reimburse MePay Directly to Supplier
Requests for direct payment must be submitted at least 10 days before the due date.
Reimbursements*
Electric Vehicle Charging*

Cents per KM MethodActual Cost Method
Please upload a photo of your odometer, capturing the entire dashboard and a copy of your current power bill.*

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Itemised power bill with the itemised line for your at-home vehicle charger / valid invoice or receipt from a fast charge (not a screenshot of a bank account).

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Proof of payment as a valid Tax Invoice (containing the supplier’s ABN and tax breakdown of expense)*

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Please enter your Bank details for reimbursement*
Proof of payment and Renewal/Policy documents (including tax breakdown)*

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Please enter your Bank details for reimbursement*
Please upload Tax invoice / Receipt / Proof of payment*

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Please enter your Bank details for reimbursement*
Pay to Supplier*
Valid Tax Invoice (containing the supplier’s ABN and tax breakdown of expense) and supplier payment details*

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Complete Renewal/Policy Documents (including tax breakdown) and supplier payment details*

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Please upload Tax invoice / Receipt / Proof of payment*

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Expense Claim Amount
total expense claim (including gst)
Expense Claim Amount*
total expense claim (including gst)
Please enter your Bank details for reimbursement (leave blank if "Pay Directly to Supplier selected)