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Mileage Reimbursement Form
Free mileage reimbursement form template for an employee claiming reimbursement for business use of their personal vehicle.
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- Free, always
This free mileage reimbursement form covers Reimbursement Rate, Approval with 11 clearly marked [placeholder] fields to fill in — built for small businesses and individuals documenting a loan or expense putting financial terms in writing so both sides have a clear, shared record. Copy it into your own word processor, fill in the placeholders, and review it — or adapt it — before use. It's part of docstoc's free document template library, alongside business, legal, real estate, finance, and HR templates. Every template here is free to copy with no signup required, and each one carries a plain disclaimer: this is a starting point for informational purposes, not a substitute for advice from a licensed professional in your jurisdiction.
Mileage Reimbursement Form
Employee: [Name] · Period: [Start Date] – [End Date]
| Date | From | To | Purpose | Miles | Rate | Amount |
|---|---|---|---|---|---|---|
| [Date] | [Location] | [Location] | [Purpose] | [Miles] | [Rate] | [Amount] |
| [Date] | [Location] | [Location] | [Purpose] | [Miles] | [Rate] | [Amount] |
Total Miles: [Number] · Total Reimbursement: [Amount]
Reimbursement Rate
Using [Company rate / current IRS standard mileage rate] of [Amount] per mile.
Approval
Employee signature: ______________________ Date: ____________ Manager approval: ______________________ Date: ____________
*Recording the specific business purpose for each trip (not just the mileage) is what actually makes this reimbursement compliant and audit-proof, both for the company and for the employee's own tax records.*
Edit directly in the box above. Download PDF anytime — the docstoc.io footer is always included and cannot be removed.
What's included
- Edit online — click the document, fill in placeholders, download a PDF
- 2 standard sections: Reimbursement Rate, Approval
- 11 clearly marked [placeholder] fields for quick personalizing
- Free to use — no account or signup required
- Fully editable — adjust any clause to match your actual situation
- Includes a signature block, ready to print or sign digitally
- Fixed docstoc.io footer on every PDF (not removable)
Who this template is for
Freelancers & solo founders
Handling routine business paperwork without commissioning custom legal drafting for every document.
Small businesses
Standardizing recurring documents — leases, agreements, notices — across a growing operation.
Anyone reviewing before signing
Using a clear starting structure to understand what a document should cover, even if a lawyer finalizes it.
Informal lending & reimbursements
Money changing hands between people or a business and its team, without a bank's paperwork.
FAQ
Is this mileage reimbursement form template really free?
Yes. Like every template in docstoc's library, this mileage reimbursement form is free to use, with no account or signup needed to view, edit, or download it.
What does this mileage reimbursement form cover?
This finance template includes Reimbursement Rate, Approval. Fill in the [bracketed] placeholders, edit any clause online, then download a PDF — the docstoc.io footer stays on every export.
Is this legal advice?
No. This covers the standard structure, not the interest-rate limits, disclosure requirements, or tax implications that can apply depending on your state and the amount involved. Check those specifics with an accountant or financial attorney before you rely on it.
Can I edit the wording?
Yes. All 11 placeholder fields and every clause are editable right on the page — change what doesn't fit, then download an updated PDF anytime.
Where can I find more free templates like this?
Browse more free finance and related document templates in the docstoc library at /document-templates/.
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Templates are drafted for general use, not a substitute for legal advice — check the note on each page for specifics.
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Copy the subject and body directly — no form to fill in, no export step, no waiting on a download link.
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API available
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