Mileage Reimbursement Form Template
Free mileage reimbursement form template for small businesses. Includes date, destination, purpose, miles driven, rate, and total columns for easy tracking.
Last updated: 2026-02-09
Mileage Reimbursement Form Template
When employees use their personal vehicle for business -- driving to client sites, making deliveries, running to the supply store, or traveling between work locations -- they deserve to be compensated for the wear, tear, and fuel. This mileage reimbursement form template gives you a clean, ready-to-use document for tracking and submitting business miles.
The form includes all the standard fields: date, starting point, destination, purpose, miles driven, reimbursement rate, and totals. Employees fill it out as they go, and you have a clear record for processing payments and keeping your books in order.
When to Use This Form
- Employees drive their personal vehicles for any business-related purpose
- You need a consistent way to track and approve mileage claims
- You are setting up a mileage reimbursement process for the first time
- Your accountant has asked for better documentation of vehicle expense deductions
- You want to replace informal tracking (sticky notes, text messages) with a proper form
Mileage Reimbursement Form
Company Name: [Company Name]
Employee Information
| Field | Details |
|---|---|
| Employee Name | _______________________________________ |
| Employee ID / Number | _______________________________________ |
| Department | _______________________________________ |
| Manager Name | _______________________________________ |
| Reporting Period | From: ____/____/____ To: ____/____/____ |
Vehicle Information
| Field | Details |
|---|---|
| Vehicle Make and Model | _______________________________________ |
| Vehicle Year | _________________ |
| License Plate Number | _______________________________________ |
Mileage Log
Record each business trip below. Use one row per trip. Round miles to the nearest whole number.
| Date | Starting Location | Destination | Business Purpose | Odometer Start | Odometer End | Total Miles |
|---|---|---|---|---|---|---|
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
| ____/____/____ | _________________________ | _________________________ | _________________________ | __________ | __________ | __________ |
Additional Expenses (Tolls and Parking)
Record any tolls or parking fees incurred during business travel. Attach receipts where available.
| Date | Description (Toll / Parking) | Amount | Receipt Attached? |
|---|---|---|---|
| ____/____/____ | _________________________________ | $__________ | [ ] Yes [ ] No |
| ____/____/____ | _________________________________ | $__________ | [ ] Yes [ ] No |
| ____/____/____ | _________________________________ | $__________ | [ ] Yes [ ] No |
| ____/____/____ | _________________________________ | $__________ | [ ] Yes [ ] No |
Reimbursement Calculation
| Item | Amount |
|---|---|
| Total Business Miles (from log above) | __________ miles |
| Reimbursement Rate | $__________ per mile |
| Mileage Reimbursement (miles x rate) | $__________ |
| Total Tolls and Parking | $__________ |
| Grand Total Reimbursement Requested | $__________ |
Employee Certification
I certify that the mileage and expenses reported above were incurred for legitimate business purposes on behalf of [Company Name]. I have not included any personal mileage or non-business expenses. The information is accurate to the best of my knowledge.
| Field | Details |
|---|---|
| Employee Signature | _______________________________________ |
| Date | ________ / ________ / ________ |
Manager Approval
| Field | Details |
|---|---|
| Manager Name (printed) | _______________________________________ |
| Manager Signature | _______________________________________ |
| Date | ________ / ________ / ________ |
| Approved Amount | $__________ |
| Notes | _______________________________________ |
For Accounting Use Only
| Field | Details |
|---|---|
| Received by | _______________________________________ |
| Date Received | ________ / ________ / ________ |
| Payment Method | [ ] Payroll [ ] Separate Check [ ] Direct Deposit |
| Payment Date | ________ / ________ / ________ |
| GL Account Code | _______________________________________ |
How to Customize This Template
- Set your reimbursement rate. Most businesses use the IRS standard mileage rate, which simplifies tax reporting. You may also set a different company-specific rate if preferred.
- Choose your submission period. Decide whether employees submit mileage [weekly / biweekly / monthly]. Monthly submissions are the most common for small businesses with occasional travel.
- Decide on odometer readings. Requiring start and end odometer readings provides the most accurate tracking. Alternatively, you can allow employees to use mapping tools (like Google Maps) to estimate miles and remove the odometer columns.
- Add or remove columns. If your employees always start from the same location, you may remove the "Starting Location" column. If you need a project code or client name, add a column for that.
- Set a receipt threshold for tolls and parking. You might require receipts only for amounts over $[10 / 25], since toll receipts can be hard to obtain.
- Choose your format. This form works as a printed document, a fillable PDF, or a spreadsheet. A spreadsheet version can auto-calculate totals, which saves time.
What Counts as Business Mileage
Typically reimbursable:
- Driving from the office to a client site
- Traveling between two client locations
- Going to the post office, bank, or supply store for business errands
- Driving to a conference, training event, or business meeting
- Traveling to a secondary work location (if the employee has a primary location)
Typically not reimbursable:
- Daily commuting from home to the primary work location
- Personal errands run during business travel
- Detours for non-business purposes
Tips for Small Businesses
- Log trips as they happen. The most common problem with mileage reimbursement is employees forgetting to record trips. Encourage your team to log miles the same day or use a mileage tracking app.
- Use a spreadsheet. Converting this form into a simple Excel or Google Sheets template with auto-calculating formulas makes the math automatic and reduces errors.
- Review for reasonableness. When you approve a form, do a quick sanity check. If the claimed mileage for a trip to a location 10 miles away shows 50 miles, ask about it.
- Keep records. Store completed mileage forms for at least [3 / 7] years for tax documentation purposes.
- Update the rate annually. The IRS mileage rate changes most years. Update your form and notify employees at the start of each calendar year.
Tracking mileage submissions, reimbursement status, and employee expense records is simpler when everything is in one place. Boring HR's Team Tracker helps you organize employee documents and keep a clear trail of submissions and approvals.