2022-2023 form (updated July 1st with new rate)
This form is a downloadable spreadsheet. Click here to download the form.
- Download and save the form to your device.
- Fill one form out for each month you are claiming reimbursement for.
- Mileage for any given day should be on the line for which the day of the month corresponds with the number on the left-hand side of the sheet. For example, travel on January 10th should be on the line with the number 10 on the left-hand side.
- After you print the form out, you will see a place to put the month in the top left corner.
- All forms must be signed by you and then by your supervisor. (Digital signatures are not accepted.)
- This is a one-page document, so please print it on one page, portrait.
- Please, DO NOT ALTER this form.
- Please have your Supervisor sign it, and then send it to the county office.
- Submit your forms monthly.