Nurse on Call
                                                                                                           TRAVELLING EXPENSES SHEET
          Name: _________________________________   NOC ID No:   ____________
          Mobile No:         PLEASE ADVISE IF THIS HAS CHANGED
                                                                                                      Specify Clearly Miles or KMs:
          Car Reg. No.                                                                                     Engine Capacity/C.C.=
                                                                                   Journeys                                Number of              Hours away               Subsistence                  Summary
                                            Date                                                                            Miles/KM                from HQ            Allowance Claim €                Of Duties
          Client Name                                                  From                              To
                                                                                            Sub Totals 
                                                                                                                                                                 CALCULATION
                                                                                                                             Km/miles                 Rate                                                     €
                                                                                                               Totals:
          Approved By: Signature:             _  _   _  __________________________                                        Print Name: _________________________
          Title of Approved Signature:  __________________________                                                        Date: __________________________
          Nurses Signature : _____________________________________ Date: ______________________
          Form No: 211                    Revision Status: 3
   Re: IMPORTANT Guidelines for Nurses when submitting travel expenses/mileage sheets
   For the attention of any Nurses who incur Mileage Expenses in doing agency work, 
   for example Nurses who are working in the Community/PHN depts, CIT etc…
   Please find above copy of the expenses sheet which you should and are to use for any 
   expenses submitted to Nurse On Call payroll dept  for payment. 
   Please print this sheet and use it if you are not doing so. Should you ever mislay your travel/expense sheet
    you can log onto our website at any time and print it off from there either, the link
   for this attachment on the website is: http://www.nurseoncall.ie/agency-forms-to-download.26.html
   We have had different expense sheets submitted and some of them are copies or originate from a HSE 
   sheet that was coloured in nature and when copied comes out darker, un-readable and causes problems. 
   We must be clearly able to read and see all details on the sheet submitted to us. 
   Guidelines for submitting expense/mileage travel sheets:
          (1)   Ensure you specify whether your travel is in miles or kilometres
          (2)   Your car engine size must be on each sheet submitted
          (3)   LEGIBLE and CLEAR hand writing for everything on the sheet
          (4)   Don’t squash the information, use multiple sheets if necessary
          (5)   Your total miles or KMs at end must add up correctly
          (6)   Your expenses sheet must be signed and verified and this persons printed name and title must be included
          (7)   Do not hold onto your expenses sheets for long periods. They should be submitted regularly as and when worked. 
   If we cannot clearly read ANY of the details on the travel expenses sheet submitted they will be 
   returned to you unpaid by post to be resubmitted when corrected.
   General Payroll Guidelines:
   Receipt of expenses sheets will not be verified. Sorry. Either scan and email or post them that's the most
    reliable route. If you are going to fax them ensure they are turned the correct way and that whoever is 
   operating it knows what they are doing (unclear sheets cannot be paid). The accounts email address
   is= nursesaccounts@nurseoncall.ie or post to Nurses Accounts, Nurse On Call, 16 Harcourt Street Dublin 2
   Payroll queries can only be dealt with by email. If you can't email the best thing to do would be to 
   write your query and post it to Nurses Accounts, Nurse on Call, 16 Harcourt Street Dublin 2
   Payment problems only arise when people fail to follow the instructions, apologies if this sounds rude but it
   is true. We are sorry but all time sheets incorrectly or unclearly filled out now will be discarded and not paid.
   We thank you for your cooperation in this regard.
   Many Thanks & Kind Regards
   Payroll Dept 
   Nurse On Call
   Email: nursesaccounts@nurseoncall.ie