Printable mileage sheets

Use this form to report mileage and fuel information for each trip. Keep completed reports for your records and do not submit this with your tax return or renewal. For audit purposes, keep records for up to 4 years for IFTA and 6-1/2 years for IRP. See next page for instructions. Use of this form is suggested; not required.request one be mailed to you, or you may download and print this form at • Mileage is reimbursed based on HHSC established rates. Reimbursement funds will be provided electronically on your MTM Re-Loadable Debit Card. • A one-way trip is from your home to the Medicaid/CSHCN appointment. A round trip is from your home to theNAME (print) TITLE SIGNATURE. DATE (mm/dd/yyyy) INDIVIDUAL VEHICLE DISTANCE AND FUEL REPORT. MCTS 270 (01/25/2019) Purpose: Use this form to record distance and fuel used for a trip or day of activity for a single vehicle. Instructions: Follow the instructions on back of this form. File and maintain completed form for four years. CARRIER ...Missouri Department of Social Services is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.If you would like to print copies of employee W-2 forms or other forms for your records, see How to view or print filed tax copies in the Payroll Tax Center for steps. Fold your W-2 forms along the second perforation, with the fold inserted in the bottom of the envelope.The organizations develop a template or use an already available ready-made format from the online sources or programs, such as Microsoft Excel, and customize them to track and record the mileage details. Furthermore, now, there are many mileage applications as well, in which one can easily record the mileage details on the go.MAS Individual Trip Request Form and Transportation Request Spreadsheet - both forms can be faxed to MAS, at (315) 299-2786. The Transportation Request Form can be filled out to request a single trip. Use the Transportation Request Spreadsheet for multiple rides