Personality Disorder Development Programme
Oxfordshire, Berkshire and Buckinghamshire Mental Health Trusts

STARS TRAVEL CLAIM FORM

 Name:……………………………………………………………………….Cost Centre: AAWCO8  Subjective:72700
Address:…………………………………………………………………….

 ………………………………………………………………………………….      

Date of travel

Mileage, stating journey. Car registration, make and engine size 

Train, bus travel. Taxi only by prior consent (include receipts)

Include names of passengers if claiming additional 2p/mile 

Parking (attach receipts)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total miles:

Total:

                              

Total:

 

 

 


 

I declare that this claim is in respect of  travel expenses due to me

 Signed by claimant:  ……………………………………………..

 Date: ……………………………………….

 Certification of Authority

I certify that the travel expenses claimed are due to be paid and were necessarily incurred

 Signed ……………………………………….

 Date………………………………………….

 

Please return to Sue Robinson - PO Box 2334 - Reading - RG4 7ZE