UNIVERSITY OF SOUTH WALES
                                    EXTERNAL EXAMINER CLAIM FOR TRAVEL, SUBSISTENCE AND OTHER EXPENSES - TREFOREST PAYROLL ONLY
       FOR COMPLETION BY CLAIMANT (Block Capitals please - see notes overleaf)                                                                                                                FOR COMPLETION BY CLAIMANT (Block Capitals please - see notes overleaf)
        Pay number                                                                Month of Claim                                                                                              CUMULATIVE BUSINESS MILEAGE TO DATE ( including this claim)                                                                                        
       NAME:(Prof/Dr/Mr/Mrs/Miss/Ms                                                                                                                                                           FORMS SUBMITTED WITHOUT THE ABOVE INFORMATION WILL BE RETURNED
       Home Address:                                                                                                                                                                          (FOR CURRENT TAX YEAR 1st April- 31st March) - ALL MILAGE OVER 10000 IN ANY TAX YEAR WILL BE PAID AT THE 
                                                                                                                                                                                              LOWER RATE IN FORCE
                                                                                           Postcode:                                            
       Department:                                                                                                                                                                                                        FOR COMPLETETION BY SPENDING DEPARTMENT
     Normal Place of Work (including Postcode)                                                                                                                                                                    AMOUNT                                                        EXPENDITURE CODE
       I confirm that I have necessary car insurance for business use for the following mileage claim   Yes/ No 
               Category                                                                                                                                      £                      Category                               £                           Nominal                         Dept Code                            Third Level
                 0         1        MILEAGE ALLOWANCE                                  0.00          miles at           40 p per mile                                                   0              1                                                                                                                                              
                                    MILEAGE ALLOWANCE                                  0.00          miles at           13 p per mile
                 0         2        SUBSISTENCE………………………………………………………..                                                                                                                  0              2
                 0         3        TRAVELLING EXPENSES ( inc. Rail/Bus/Train/Toll/Parking)                                                                                             0              3
                 0         4        TELEPHONE RENTAL (Non-Taxable) ……………………                                                                                                             0              4
                 0         5        BUSINESS TEL CALLS  …………………………………...……..                                                                                                            0              5
                 0         6        POSTAGES (Summary Attached)( Non-Taxable)…                                                                                                          0              6
                 0         7        MISCELLANEOUS EXPENDITURE …………......…………                                                                                                            0              7
                 0         8        INCIDENTALS …………………………………………...…………                                                                                                                 0              8
                 0         9        ADVANCE……………………………….….…………………...…                                                                                                                   0              9
     *All relevant receipts are attached as detailed overleaf.                                                           TOTAL  CLAIM                        £0.00                           TOTAL                           0.00
     I certify that this claim is correct and in accordance with the Scheme for the reimbursement to staff of properly and necessarily incurred expenses and that I have                      I certify that this claim is correct and in accordance with the Scheme and the journeys undertaken 
     actually undertaken the journeys shown which were necessary for work purposes and that I have actually incurred additional expenditure. I certify that I have                            were necessary.
     Incurred Petty Cash expenditure as detailed above.
                                                                                                                                                                                     Print Name of Authorising Officer
     Signed:                                                     Claimant                            Date:                                                                          Signed:                                                                Head of Department                                      Date:
                                                                  PLEASE NOTE: INCOMPLETE OR UNAUTHORISED CLAIMS WILL BE RETURNED TO THE CLAIMANT
                                                                                    PLEASE SEND COMPLETED FORM TO THE PAYROLL OFFICE - payroll@southwales.ac.uk
    Travelling and Other Expenses
   Date and              Departing  Places Visited  and Route taken*                                                                                                                                                         Misc and 
            Time *       From *                              (where milage claim inc             Purpose of Visit         Date and                      Mileage travelled   >150miles         Other                            Other 
                                                            postcode)                                                                   Returning to*  up to 150 miles at  roundtrip at     travelling      Expenses         Expenses     Incidentals        
                            (place)                                                                                         Time*          (place)            40P              13P          Expenses      Description         (value)    Desc'n      Value
                                                                                                                                                                                                                                                       
                                    Totals Carried Forward Overleaf:                                                                                         0.00             0.00           £0.00                            £0.00                £0.00
  * Where indicated this  is required information for all trips
  Subsistence allowances
                                                                                           Receipt 3                             
                 Receipt 1                              Receipt 2                                                                                 Receipt 4                                     Receipt 5                                 Total Receipts 
      Date                      Value                                 Value                            Value                                       Value                            Value                     Value        Daily Total Claimed £
                                                                   Totals Carried Forward Overleaf:                                                                                                                                  £0.00
                                                                                                                                 Currency conversion rates £1 = : _______
  NOTES
  1. All Claimants should be fully conversant with the scheme for the payment of expenses.
  2. All columns of the log sheet above must be completed at the commencement and termination of each journey.
  3. Claims for travel by bus/taxi and for toll and parking fees should be recorded on the column headed “Other Travelling Expenses”.
  4. Where more than one log sheet is used in a claim period, totals should be carried and summarised on the claim form only for that period.
  5. All relevant sections of the claim form must be completed otherwise the claim form will be returned.
  6. Claim form and log sheet must be completed legibly.
  7. All claims over £1000 must be authorised by the Head of Finance.
  8. Re-imbursment can only be made against receipt except for exceptional circumstances where a case must be made.
  9. Mileage travelled can only be claimed where it is greater than the normal travel to work, and then only the excess may be claimed.