Vehicle Mileage Log

COMPANY LETTERHEAD

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

VEHICLE MILEAGE LOG

Employee Name: {{employee_name}}

Department: {{department}}

Employee ID: {{employee_id}}

Reporting Period: From {{start_date}} to {{end_date}}

VEHICLE DETAILS

Make: {{vehicle_make}}

Model: {{vehicle_model}}

Year: {{vehicle_year}}

License Plate: {{license_plate}}

Starting Odometer Reading (at start of period): {{starting_odometer}} km

MILEAGE RECORD

Complete the table below for each business trip. Ensure all fields are filled accurately.

Date: {{date}}

Time Out: {{time_out}}

Time In: {{time_in}}

Starting Location: {{starting_location}}

Destination: {{destination}}

Purpose of Trip: {{purpose_of_trip}}

Starting Odometer Reading: {{trip_start_odometer}} km

Ending Odometer Reading: {{trip_end_odometer}} km

Mileage for Trip: {{trip_mileage}} km

Toll/Parking Fees: R {{toll_parking_fees}}

Notes: {{notes}}

Repeat above fields for each trip entry.

SUMMARY FOR REPORTING PERIOD

Total Business Mileage for Period: {{total_business_mileage}} km

Total Personal Mileage (if applicable): {{total_personal_mileage}} km

Total Parking/Toll Fees: R {{total_parking_toll_fees}}

Ending Odometer Reading (at end of period): {{ending_odometer}} km

EMPLOYEE DECLARATION

I, {{employee_name}}, declare that the information provided in this Vehicle Mileage Log is true and accurate to the best of my knowledge. I understand that false declarations may result in disciplinary action and/or legal consequences.

Employee Signature: _________________________ Date: {{declaration_date}}

AUTHORISATION (FOR OFFICE USE ONLY)

Approved by: {{approver_name}}

Title: {{approver_title}}

Date of Approval: {{approval_date}}

Signature: _________________________