Standard Mileage Log Template - Carolina Therapy Services
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1Carolina Therapy Services
Standard Mileage Log
Name
Date(s) Covered
Facility to
Date
From
To
Business Purpose
Mileage
Charge
Total Miles
-
Rate per Mile
$
0.500
Employee's Signature:
Amount Due
Approver's Signature:
0
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Parent category: Miscellaneous