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This document is used for submitting mileage requests for trips exceeding 5 miles round trip to obtain medical care or purchase medically related items.
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How to fill out MILEAGE REIMBURSEMENT

01
Gather all necessary documentation, including mileage logs and receipts.
02
Calculate the total number of miles driven for work purposes.
03
Find out the current reimbursement rate per mile set by your employer or government.
04
Multiply the total miles driven by the reimbursement rate to determine the total amount owed.
05
Fill out the mileage reimbursement form accurately, entering your personal information and mileage details.
06
Attach any supporting documentation, such as mileage logs or maps showing your routes.
07
Submit the completed form and documentation to the appropriate department or manager for approval.

Who needs MILEAGE REIMBURSEMENT?

01
Employees who use their personal vehicles for work-related tasks.
02
Contractors or freelancers who incur mileage expenses while performing services for a company.
03
Anyone who travels for business meetings, client visits, or work-related errands and seeks compensation for their travel costs.
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Business: 70 cents/mile. Charity: 14 cents/mile. Medical or moving: 21 cents/mile.
The IRS specifies: Record the odometer reading at the start of each trip and list the purpose, starting location, ending location, and date of the trip. After the trip, the final odometer must be recorded and then subtracted from the initial reading to find the total mileage for the trip. 11.
Employee mileage reimbursement is tax-free for employers in California. However, this rule applies as long as your company's mileage rate is not more than the current standard mileage rate issued by the IRS. As of 2025, the IRS mileage rate for business related travel is 70 cents per mile.
What does the IRS require for mileage logs? In short, you have to keep a mileage log that demonstrates the following: The distance traveled, the number of miles driven for each work trip, as well as the date, time, and destination of each trip.
The IRS specifies: Record the odometer reading at the start of each trip and list the purpose, starting location, ending location, and date of the trip. After the trip, the final odometer must be recorded and then subtracted from the initial reading to find the total mileage for the trip. 11.
To calculate actual expenses, figure out what percentage of your car you used for business purposes. You can do this by dividing your business miles driven by your total annual miles. Next, multiply your business use percentage by your total car expenses.
When deciding how to charge mileage to customers, you have several options: you can bundle the charge with your service, ask for a flat rate for distance ranges, charge per mile or per hour of driving, or use a hybrid system of a flat and variable rate.
There's no required mileage log template: you can use a paper log book, a spreadsheet, or even a mileage tracking app to log your mileage. The IRS does provide a business mileage and expense log example template in part 5 of Publication 463, which covers recordkeeping requirements for vehicle expenses.

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Mileage reimbursement is a payment made to employees or individuals to cover the costs associated with using their personal vehicle for business purposes. This reimbursement compensates for expenses such as fuel, wear and tear, and maintenance.
Employees who use their personal vehicles for work-related travel are typically required to file mileage reimbursement claims. This can include traveling to client meetings, job sites, or other business-related functions.
To fill out a mileage reimbursement claim, individuals generally need to provide the date of travel, starting and ending location, purpose of the trip, total miles driven, and any other required documentation as specified by their employer.
The purpose of mileage reimbursement is to reimburse employees for the out-of-pocket expenses incurred while using their personal vehicles for business purposes, ensuring they are not financially burdened for work-related travel.
Mileage reimbursement claims must report the date of travel, starting and ending odometer readings, total miles driven, the purpose of the trip, and any relevant receipts or documentation as required by the employer's policy.
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