Executive and Committee Members Expense Claim Form

Complete a separate form/submission for EACH meeting you attend. If you are claiming items in OTHER EXPENSES, receipts will be required. It is recommended that you print your submission to PDF before selecting "SUBMIT" to retain a personal record. You will receive a confirmation email of your submission.

Please refer to the Executive Manual for more information about committees and expenses allowed or contact the Association office.

Name(Required)

First Last

Email(Required)

Division/District(Required)

Please refer to the Executive Manual for more information about committees and expenses allowed.

Activity or Committee Work(Required)

Select only ONE activity or committee please.

Hidden

GL Code

Hidden

GL Code

MSBA - Other

Describe event or activity (e.g. ad hoc committee, workshop presenter, traditional teacher)

If MSBA Other - enter $ amount to be claimed

Meeting Date(Required)

Per Diems(Required)

None

1/2 day ($65 per diem)

Full day ($130 per diem)

Executive Meeting/Regional Meeting/Retreat ($150 per diem)

Teleconference ($30/hour)

Teleconference Hours

Round numbers only; no fractions or decimals.

Mileage (Kilometers)

Rural/Urban - total # kms driven

Kilometer rate - $0.64 per km

Rural/Urban - Mileage Claim Amount

Rural Residents Only (kms travelled beyond the perimeter)

Please enter a number from 0 to 300.

Kilometer rate of $15¢ per km (maximum $45) when attending meetings as compensation for travel time (only eligible when claiming a per diem).

Rural Residents ONLY - Mileage Claim Amount

Maximum is $45.00. Payable only when claiming a per diem.

Meals & Incidentals (MB/OOP rates) [REMINDER: Out of Province (OOP) maximum rates are applicable ONLY for meal expenses incurred while outside of Manitoba.]

*Breakfast ($20.00 MB/$25.00 OOP)

Please enter a number less than or equal to 25.00.

*Lunch ($25.00 MB/$30.00 OOP)

Please enter a number less than or equal to 30.00.

*Supper ($35.00 MB/$45.00 OOP)

Please enter a number less than or equal to 45.00.

Incidentals ($5.00)

Please enter a number less than or equal to 5.00.

*REMINDER: claim Manitoba rate (lower $ amount) unless meal expenses were incurred outside of Manitoba.

Total Meals/Incidentals

Reimbursement for Other Expenses(Required)

Receipts required for: accommodations, parking, car rental, and other business related expenses

Yes, submit receipts (reimbursement amount below)

Reimbursement Amount for Other Expenses(Required)

Receipts for Other Expenses(Required)

Receipts required for: accommodations, parking, car rental, and other business related expenses.

Drop files here or

Accepted file types: jpg, pdf, gif, Max. file size: 10 MB.

Total Claim Amount

Per Diem, Mileage(s), Meals, & Other

Be careful! Once the form is submitted it cannot be recalled. Please contact accounts@mbschoolboards.ca if you have accidently submitted a form.

Executive and Committee Members Expense Claim Form

Executive and Committee Members Expense Claim Form

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Acknowledgement

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