ADMIN MILEAGE TRACKER

1
Date of Trip* This field is required.
Date
Year
Month
Day
2
Name* This field is required.
First Name
Last Name
3
Starting Location* This field is required.TYPE THE STARTING ADDRESS ONLY
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Ok
4
Ending Location* This field is required.TYPE THE ENDING ADDRESS ONLY
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Ok
5
# of Miles* This field is required.WRITE THE NUMBER ONLY. Please do not put the word miles in the box.
6
Reason for trip?* This field is required.
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Ok
7
License Plate # * This field is required.Please write the plate # only
8
Signature* This field is required.
9
Mileage reimbursement may be provided for approved work-related travel, including but not limited to:

● Client home visits

● New client consultations and assessments

● Supervisory/Random Visits

● Nursing assessments and skills checks

● Community partner meetings and case management meetings

● Recruiting events and job fairs

● Approved training programs

● Authorized supply pickups or business errands

● Travel between business locations during the workday

● Other travel specifically authorized by management

NON-REIMBURSABLE TRAVEL The following travel is not eligible for mileage reimbursement:

● Daily commuting between an employee's home and the Nattingham Home Care office

● Personal errands conducted during work hours

● Travel unrelated to company business

● Unauthorized travel expenses

● Mileage that cannot be reasonably verified
Should be Empty: