Forms · PDF
Mileage reimbursement form (PDF)
Printable PDF to attach to the reimbursement process — signature fields for employee, manager, and finance.
Even in the digital era, many companies still require a physical form (or signed PDF) attached to the reimbursement process. This form covers the minimum fields required by most internal audits: employee ID, period, trip list, claimed total, and signatures from employee, manager, and finance. Print, fill, scan, and attach — or use a PDF reader to fill it digitally.
When to use this template
Use when your reimbursement process still requires a signed document (by internal policy or union requirement), or when you must attach physical evidence to a tax audit. Companies operating 100% digital can skip this form and use the online calculator instead — it generates an equivalent numbered receipt without needing a wet signature.
How to use in 5 steps
- 1. Print or open in a PDF editor — Adobe Reader, Foxit, Preview (Mac), or Drive allow digital fill-in. For wet signatures, print.
- 2. Fill in the header — Name, employee ID, department, period. Use legible handwriting or digital text.
- 3. List each trip — Date, origin, destination, purpose, miles. Business purpose is the most audited column.
- 4. Sum the total and rate — Total miles × per-mile rate = amount due. Validate against policy before signing.
- 5. Collect all 3 signatures — Yours, manager's, and finance's. Without all 3, payment is delayed.
Common pitfalls
- Not numbering the form — Number each form (e.g. REQ-2025-001) for easy tracking.
- Forgetting attachments — The form is a summary; substantiating documents (log, tolls) must accompany it.
- Illegible handwriting — If filling by hand, use block letters. Illegible writing stalls in finance.
- Undated signatures — Each signature needs a date — without it, it is hard to prove the approval flow.
Frequently asked questions
- Can I edit the fields?
- The PDF is fixed text, but you can use Acrobat Pro to add fillable fields. For full editing, request our DOCX version (in development).
- Does it work as a tax receipt?
- No. It is an internal reimbursement document. For a tax receipt, use the online calculator which generates a sequentially numbered receipt.
- Is there a multi-month version?
- No. One form per month keeps audits clean.
- Does it accept digital signatures?
- Yes — any legally valid e-signature (Adobe Sign, DocuSign) works.
- Is the PDF editable?
- Fixed text by default. For free editing, open with Acrobat Pro or convert to Word.
For teams looking to eliminate paper entirely, the online calculator generates digital receipts with sequential numbering and your company logo — equivalent to this form but processed in seconds.