Certified Claim for Fees and Associated Expenses (Staff Claimant

By Brian Rivera,2014-05-15 15:11
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Certified Claim for Fees and Associated Expenses (Staff Claimant


This form is for use by University of Sheffield Staff Claimants who have completed additional work and incurred

    expenses associated with the work see guidance notes overleaf. Payment will be included with your monthly

    salary and is subject to income tax and employee’s national insurance.

    Please complete this form using clear, block capital letters, sign and date and pass to your departmental office

    for completion and approval by an authorised signatory. Once this form has been signed, please return to

    Pay & Pensions Office, Finance Department, Firth Court, Western Bank, Sheffield, S10 2TN.

     Name: Department:

    Payroll Number: Faculty:

    N I Number: Post Number:

    Dates work Description of the work undertaken and the expenses Amount completed incurred ? p


     EXPENSES: (attach all receipts)

     ? p

    Claimant Approved by authorised signatory



    Signed Signed Date Date


    FIN/SSO/7 This section should be completed by Departmental Finance staff before sending to the Pay and Pensions Office

    in the Finance Department. Please contact the Tax team on extension 21517 if you have any queries relating to

    the VAT code.

    For departmental office use only Gross: ? Cost Centre or WBS Code Expenses Type Code Gross ? p VAT Code

    Staff are encouraged to maintain a personal record of all expenses incurred on University business which are reimbursed, and for all grants received towards research and travel expenses incurred both in the UK and overseas. The University’s

    records of payments are the subject of scrutiny by Revenue & Customs.





General information

1. All fields must be completed.

2. Full details of the nature and purpose of the expenditure should be provided.

3. Original receipts are required to support all expenditure. Credit/debit card receipts cannot be

    accepted as they do not itemise goods and services purchased, nor do they show the VAT

    element of the purchase.

4. Claims for the following should be supported by the relevant additional form(s) (details in


    ? Essential Car Travel (Record of Mileage Form FIN/CAR/1)

    ? UK and Overseas Travel and Accommodation (Travel and Accommodation Form


    ? Hospitality for additional, staff or non-staff, guest(s) (Hospitality Form FIN/HOS/1)

5. For National Insurance purposes the stand and end dates over which the work was completed

    must be provided.

6. Claimants must sign to indicate that:

    (i) they have appropriate insurance cover where their own car has been used on University


    (ii) the expenditure has been incurred wholly, necessarily and exclusively on University


    (iii) they have complied with the Financial Directives.

7. The claim must be signed by an authorised signatory as notified to the Payments Office, Finance


8. Failure to comply with the Financial Directives and procedures will result in the claim form being

    returned to the authorised signatory with consequential delay in payment.




1. Requests for payment to organisations should be made by submitting an authorised invoice.

2. Staff claims for expenses without a fee payment should be made on an Expenses Claim Form.

3. Claims for expenses against the Learned Societies Fund should be made on a Learned Societies

    Fund Application Form.

4. Non-staff claimants should follow Human Resources policies for University Bank Workers.


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