SAMFORD UNIVERSITY
Human Resources Department
Auto Mileage Report
Please complete an Auto Mileage form with information for each vehicle used during
the period covered. Payroll will deduct taxes on the next available pay period. These
should be completed a minimum of annually (to be completed each December) but may
be completed at quarterly intervals throughout the year to allow the tax deductions to
be spread over multiple pay periods.
The IRS requires a log to be kept to substantiate all business use for University
provided vehicles which includes the: date, destination, mileage, and business purpose.
All other mileage is deemed by the IRS to be personal and thus taxable to the
employee.
Employee Name: _____________________________ SUID ______________________
Beginning Date: ______________________ Ending Date: ________________________
Vehicle Make: _______________ Vehicle Model: ______________ Year: ____________
Beginning Mileage: ___________________ Ending Mileage: ______________________
Total Miles: ________________________ Personal Miles: ________________________
Beginning Date: ______________________ Ending Date: ________________________
Vehicle Make: _______________ Vehicle Model: ______________ Year: ____________
Beginning Mileage: ___________________ Ending Mileage: ______________________
Total Miles: ________________________ Personal Miles: ________________________
________________________________ ________________________________
Employee Signature Date
HR USE ONLY
Value
ALV
Percentage
Taxable Amount