PRIVATE MOTOR VEHICLE USAGE CLAIM FOR JCU BUSINESS TRAVEL - PART 1
PRIVATE VEHICLE DETAILS
Make
Model
Year
Body Type
Registration Number
State Registered
Is the vehicle salary sacrificed under a University FRP (If Yes, payment CANNOT be claimed)?
Why is it neccessary to use a private vehicle?
DRIVER DETAILS
Do you have a valid Australian driver's license?
Do you have a valid vehicle registration?
Do you have a valid full vehicle comprehensive insurance policy?
If any of the above three questions are answered "No", then the private vehicle can NOT be used for any JCU related business travel.
DISCLAIMER:
The University is not liable for any loss, damage or expense suffered or incurred by any person arising out of or in connection with the
use of the private vehicle for business travel.
Travellers must ensure that their vehicle is covered for business travel.
In the event of an accident involving a private vehicle whilst on University business, any insurance claim which may arise must be
made through the vehicle owner’s insurers. It is NOT possible for any insurance claims to be made under the University’s insurance
policies.
ESTIMATION OF PRIVATE MOTOR VEHICLE EXPENSES
Option 1
Mileage Allowance
(Use Code 7619)
Lower of A and B
A. Cents Per Kilometre
Origin
Destination
Distance (km)
Cents/Kilometre
Estimate
$0.00
Useful estimation tool - RACQ Trip Planner website
http://www.racq.com.au/travel/Maps_and_Directions/trip_planner_2
http://www.jcu.edu.au/policy/finance/expenses/JCUPRD_037508.html
For current cents per km rates refer to Mileage Allowance on Travel Webpage
B. Cheapest Air-Fare of the day (where one exists)
Origin
Destination
Airline
Estimate
Attach proof (e.g. quote from on-line booking tool - WTP)
Lower of A and B:
$0.00
Option 2
Fuel Reimbursement
(Use Code 7617)
Estimate:
NOTE:
A Vehicle log must be completed for the actual claim in Part 2
DECLARATION
I declare that the information provided on this form is true, correct and complete and will notify JCU of any changes:
Full Name
JCU ID Number
Signature
Authorisation
I Authorise the use of the private motor vehicle for JCU travel based on the information provided above:
Full Name
Position
Signature
click to sign
signature
click to edit
click to sign
signature
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PRIVATE MOTOR VEHICLE USAGE CLAIM FOR JCU BUSINESS TRAVEL - PART 2
On return from your trip, complete and forward this form for payment of private motor vehicle usage
Please be aware that a lot of information is required to complete this form. Failure to supply all required information will result in
delayed payment and claims may be returned for further information.
1. POSTING CODE
2. CLAIM METHOD (Please Select One)
ORGU
PROJECT
FUND
1. Mileage Allowance
Complete Sections 3 and 5 Below
2. Fuel Reimbursement
Complete Sections 4 and 5 Below
3. MILEAGE ALLOWANCE (USE CODE 7619)
•Kilometres for the trip should not include the normal daily distance from your home to your usual work campus and return.
•Payment of Mileage Allowance into the next salary run will occur if this form is received by the Salaries Section before the
Wednesday of the week before payday. JCU do not take responsibility for delayed payments due to incomplete documentation
submitted by the traveller.
•Mileage Allowances paid will appear on your Payment Summary (Group Certificate).
VEHICLE MILEAGE LOG
Date
Venue/s or
Person/s
Visited
Purpose of Visit
Odometer Readings
Total Trip
Distance
(Kilometres)
Usual KMs
Travelled To and
From Work (Daily)
KMs
Claimed
Start
End
Start
End
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total KMs Claimed:
0
LOWEST OF A AND B:
A. Cents Per Kilometre
Total Kilometres Claimed
Cents/Kilometre
Actual Amount
0
$0.00
B. Cheapest Air-Fare of
the day (where one exists)
As per Private Motor Vehicle Usage Claim - Part 1
Lower of A and B:
$0.00
4. FUEL REIMBURSEMENT (USE CODE 8015)
MUST ATTACH FUEL RECEIPTS.
Please allow 7 business days upon submission for payment by Accounts Payable. JCU do not take responsibility for delayed
payments due to incomplete documentation submitted by traveller.
Receipts Total:
5. DECLARATION
I declare that the information provided on this form is true, correct and complete and will notify JCU of any changes:
Full Name
JCU ID Number
Signature
6. TRAVEL OFFICER VERIFICATION
I Verify that:
The Part 2 claim total is no greater than the approximation made on Part 1; OR
The travel requisition part 2 has been approved by the correct authoriser for the increase in expenditure;
Full Name
Position
Signature
click to sign
signature
click to edit
click to sign
signature
click to edit
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