Post Code Invoice To: Health Education England – T73 T73 Payables F485 Phoenix House Topcliffe Lane Tingley Wakefield WF3 1WE BANK NOTE: PLEASE ENSURE DETAILS ARE ENTERED. FAILURE TO ENTER THESE DETAILS WILL RESULT IN PAYMENT DELAYS. Total Value of the Claim Please fill in the breakdown of the claim on the following page Details of the claim Travel Expenses Start Location: Finish Location: Mode of transport: Public Transport £ (Receipts must be attached) Total Number of Miles: @ 24p per mile (Mileage Private Transport £ will be calculated at quickest route) Name(s) of passenger(s): Passengers Total miles travelled with passenger (Reimbursed at 5p per mile per (Passengers must be travelling to same event & also £ passenger) entitled to reimbursement of travel expenses by the Deanery) Accommodation Expenditure £ (Receipts must be attached) Subsistence Meal Expenditure £ (Receipts must be attached) Please specify below: Other Expenses £
Post Code Invoice To: Health Education England – T73 T73 Payables F485 Phoenix House Topcliffe Lane Tingley Wakefield WF3 1WE NOTE: PLEASE ENSURE BANK DETAILS ARE ENTERED. FAILURE TO ENTER THESE DETAILS WILL RESULT IN PAYMENT DELAYS. Total Value of the Claim Please fill in the breakdown of the claim on the following page Details of the claim Travel Expenses Start Location: Finish Location: Public Transport Mode of transport: (Receipts must be attached) £ Private Transport Total Number of Miles: @ 24p per mile (Mileage will be calculated at quickest route) £ Passengers (Reimbursed at 5p per mile per passenger) Name(s) of passenger(s): Total miles travelled with passenger (Passengers must be travelling to same event & also entitled to reimbursement of travel expenses by the Deanery) £ Subsistence Accommodation Expenditure (Receipts must be attached) £ Meal Expenditure (Receipts must be attached) £ Other Expenses Please specify below: £