Expense Form – CUPE

Name: (required)

Email: (required)

Address: (required)

Postal Code: (required)

Phone: (required)

Per diem +Meeting & Travel Time (less than 4 hours) = $50.00/day (or) Per diem +Meeting & Travel Time (4 hours or more) = $80.00/day. Outside of Province $95.00 per day. (Mileage as per CUPE National) (Meeting & Travel includes meal expenses)
Date Expense Incurred	Full Details of Expense	Total
	Reason & Place:
	MT & T:
	From-To Return (if more than 10 km from residence) (KM):

	Reason & Place:
	MT & T:
	From-To Return (KM):

	Paid by Cheque#:	Cheque Date:

Date	Total Hours Of Lost Wages	Wage Rate	Total (This space for Treasurer)

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