Get The Arc Ccr Mileage Reimbursement Form 2.26.2020.xlsx

Filling out The Arc CCR Mileage Reimbursement Form online is a straightforward process that ensures you accurately report your mileage for reimbursement. This guide will provide you with step-by-step instructions to help you navigate through each section of the form seamlessly.

Follow the steps to complete your mileage reimbursement form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by entering your name in the ‘EMPLOYEE NAME’ field, ensuring it is printed clearly for accuracy. Next, fill in the ‘Month/Year’ you are submitting this reimbursement for.
3. In the ‘EMPLOYER NAME’ field, provide the name of your employer. Next, enter the department number in the ‘DEPT #’ field, which helps in tracking your submission.
4. For each trip, fill in the following fields: ‘Date’ of travel, ‘Destination’ where you traveled, and the reason or ‘Purpose’ for the trip. Input the number of ‘Miles’ driven for that trip.
5. Repeat step 4 for each trip you are claiming. Ensure to use the remaining available lines (1 to 31) to accurately record all trips for the month.
6. Upon completion of the trip entries, total the miles driven in the ‘Total Miles Driven’ field at the bottom of the section.
7. Review and select the appropriate service codes based on the services provided during the trips. Use the ‘SERVICE CODES’ section for reference to identify the correct codes.
8. Calculate your reimbursement amount by multiplying the total miles driven by the ‘Reimbursement Rate’ indicated in the form. Enter the total in the ‘Total Reimbursement Amount’ field.
9. Both the employee and employer or designated representative need to sign in the respective signature fields to certify the accuracy of the information provided and compliance with Maryland DDA standards.
10. After completing all sections, save your changes to the form. You can then download, print, or share the completed document as necessary.

Complete your mileage reimbursement form online today for a smooth reimbursement process.