
ALL ORIGINAL TRAVEL CLAIMS MUST BE SUBMITTED BY THE 10TH OF EACH MONTH AND SENT TO THE FOLLOWING ADDRESS BELOW:
ROOM 19-22 PAYROLL SERVICES DEPT,THE PENNINE ACUTE HOSPITALS NHS TRUST,NMGH,DELAUNAYS RD,CRUMPSALL,MANCHESTER M8 5RB
GP trainees ONLY
Please Use
BLOCK Post Held:
capitals Reg. No: CC : Assignment No:
1 2 3 4 5 6 7 8 9 10
F
CONTINUE OVERLEAF FOR MORE CLAIMS IF NECESSARY
0.0 0.0 0.0 0.0 0.0 0.0 0.00 0.00
AUTHORISATION AND SIGNATURES REQUIRED ON NEXT PAGE M P E MT N
F
SUBSISTENCE
Online entries in £
column only please
Please ensure that you claim mileage in accordance with the applicable policies for GP Specialty Trainees.
Any other travel expenses must be supported by invoice or receipts
Home to base return mileage:
NATURE OF
OR
REASON FOR VISIT
DETAILS OF JOURNEY
(STARTING POINT, PLACES VISITED
AND FINISHING POINT
TRAVELLING EXPENSES CLAIMS
OTHER
TRAVEL
EXPENSES
Online entries in £
column only please
TIME SPENT
ON
OFFICIAL
BUSINESS