How to use the mileage reimbursement form
- Enter your organization and a title, and a short note if needed, such as a reminder not to include a regular commute.
- Choose the number of trip rows. Each row has room for the date, where the trip started and ended, the business purpose and the miles.
- If your organization has set a rate per mile, enter it to print it on the form. Leave it blank to write it in.
- Tick the amount column if you want a cost for each trip, then print the form or save a PDF.
Filling in a claim
List each business trip on its own row with the date, the start and end places, the reason for the trip and the miles driven. At the bottom, add the miles, multiply them by the rate and write the amount. Both the employee and an approver sign and date the form.
Keep the odometer readings or a map record to support the miles. A claim with a clear purpose for each trip is quicker to approve, and the form leaves room for exactly that.
About the rate
This page does not supply a rate. Organizations set their own rate per mile, and rates for tax purposes are set by tax authorities and change over time. If you enter a rate, it is printed on the form as typed, and the form says that the organization sets it. For help with the sum itself use the Mileage Reimbursement Calculator, and for a running record use the Vehicle Mileage Log Printable.
To bundle mileage with other costs for a claim use the Expense Report Generator, and for daily travel allowances use the Per Diem Calculator.
Not tax or legal advice
This is a blank form. Rules about what you may claim, how mileage is taxed and what records you must keep depend on where you are and on your employer. Check your own policy and ask a tax professional if you are unsure. Everything is made in your browser, and nothing you type is uploaded.
Assumptions and limits
- The form is printed on US Letter paper and filled in by hand. Long lists continue on more pages.
- The rate is only what you type, and no rate is built in.
- Totals are written by hand, so the form does no arithmetic.
- The company name in the sample is made up and is there to be replaced.
Frequently asked questions
What should a mileage claim include?
The date of each trip, where it started and ended, the business purpose and the miles. Totals and the rate used follow, with a signature. This form has a space for each.
What rate per mile should I use?
Use the rate your organization has set. This tool does not supply one. If you claim mileage as a business expense on a tax return, the tax authority publishes its own rate for each year.
Does commuting count?
Rules differ. Many employers and tax systems do not reimburse the regular trip between home and the usual workplace. The sample note on the form says so, and you can change or remove it.
How many rows can I print?
From 5 to 40. The form continues over more than one page when the list is long, with the heading repeated.