Reimbursed Expenses Declaration Form

If you are looking to claim reimbursed expenses, please complete the Reimbursed Expenses Declaration form below. If you have any questions, please contact the Umbrella Company UK team on 01707 669038 or support@umbrellacompanyuk.co.uk.

Please be aware that you are completing the form for one working week (Monday - Sunday). If you started work later in the week that went beyond Sunday (e.g. Thursday - Wednesday), you will need to complete the form twice (Thursday - Sunday and Monday - Wednesday).

You cannot claim expenses for future periods.
Your Details
First Name*
Last Name*
End-Client*
Recruitment Agency*
Email Address*
Today's date
Your Expenses Claim Period
Please select the Week Commencing Date to unlock the rest of this form.
The End of Week Date will be automatically calculated based on the commencing date and cannot be altered.
Week Commencing Date*
DD slash MM slash YYYY
End of Week Date
Please confirm how many days you worked during period*
Are you claiming mileage expenses?
If you are claiming mileage expenses, please click yes. You will then be required to provide us with information about your claim and your vehicle. Don't forget to attach the relevant receipts. If you are not claiming mileage expenses, please click no and move onto the next section.
Mileage Expense Claim
You can only be reimbursed tax free mileage up to the HMRC approve mileage rate. Umbrella Company UK will verify the mileage using the postcodes provided. You need to submit copies of VAT receipts to support your mileage claim. Please also note that you must be covered with the appropriate insurance – such as business travel.

Date of the Expense	End Client	Travel To (Postcode)	Travel From (Postcode)	Amount you are claiming (£)	Distance Travelled (Miles)	Reason For Journey	Was this a return journey?	Did you make the same journey on other days in the week? If so, please select every date.

Mileage Expenses
Drop files here or

Accepted file types: jpeg, jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.
Please upload your mileage receipts using the tool above. We can accept the following file formats: jpeg, jpg, gif, png, pdf, doc, docx. If you are having problems uploading your receipts, please contact the Umbrella Company UK team.

We only accept original or scanned receipts and not credit card receipts. These are required for verification purposes. Please make sure you keep your receipts for audit purposes.
Car/Motorcycle/Bike
Make and Model
Engine Capacity CC's
Vehicle Registration
Total Miles You Are Claiming For:
Total Amount (£) You Are Claiming For:
Are you claiming additional expenses (non-mileage)?
If you are claiming expenses that are not mileage, please click yes and you will be required to provide us with information for each claim. Don't forget to attach the relevant receipts. If you are not additional (non-mileage) expenses, please click no and move on to the next section.
Date of the Expense What was the Expense? Value of the Expense (£) Reason for the Expense If this expense claim involves an overnight stay, please enter the postcode below. If not, leave blank.
Additional Expenses
Drop files here or

Accepted file types: jpeg, jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.
If you are looking to claim additional expenses, please upload the relevant receipts using the tool above. We can accept the following file formats: jpeg, jpg, gif, png, pdf, doc, docx. If you are having problems uploading your receipts, please contact the Umbrella Company UK team.

We only accept original or scanned receipts and not credit card receipts. These are required for verification purposes. Please make sure you keep your receipts for audit purposes.
Total Additional Expenses (£)
Your Address
House Number/House Name*
Street Address*
Town/City*
County*
Postcode*
Declaration
I confirm that my expenses are wholly, exclusively and necessarily incurred in the course of performing employment duties.*
I confirm that where I am claiming expenses related to travel that I am working on a temporary assignment and I do not expect continuous work at the same location for 24 months.*
I confirm that I have already, or expect to undertake more than one assignment for Umbrella Company UK and that I do not expect my current assignment with Umbrella Company UK to be my last.*
I confirm that if I am found to be falsifying expense claims I will face disciplinary action.*
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

Date of the Expense	What was the Expense?	Value of the Expense (£)	Reason for the Expense	If this expense claim involves an overnight stay, please enter the postcode below. If not, leave blank.

Expenses Declaration Form

Your Details

Your Expenses Claim Period

Are you claiming mileage expenses?

Mileage Expense Claim

Are you claiming additional expenses (non-mileage)?

Your Address

Declaration