Travel and accommodation allowance claim form for apprentices

Travel and accommodation allowance
claim form for apprentices / trainees
Eligibility requirements and payment rates can be found in the Travel and Accommodation Allowance Policy, which is
available at apprenticentre.wa.gov.au. Amounts payable for a claimed period are determined by the information provided
on this form. Non-compliant or incomplete claims may be returned without payment.
ALL RECEIPTS for paid accommodation must be attached. Forms will be returned if incomplete information is provided.
This claim must be submitted within 60 days of the last nominated training day to your local ApprentiCentre.
SECTION ONE: APPRENTICE/TRAINEE DETAILS
1.1
Surname:
1.2
DOB:
Given name(s):
/
/
and/or
TRS No
Example: 234567T2, 987654A1
1.3
Current year of apprenticeship/traineeships (please circle):
1.4
Mobile no.:
1.5
Email:
1.6
Current permanent residential address (not PO Box address):
1
2
3 4
Street address:
Suburb/town:
1.7
Postcode:
Postal address (if different from above):
Street address:
Suburb/town:
Postcode:
SECTION TWO: TRAINING DETAILS
2.1
Name of training provider:
2.2
Location of off-the-job training campus (suburb/town):
2.3
Period of attendance:
/
/
/
to
Date of first training day
2.4
Type of training release pattern (please tick):
/
Date of last training day
DAY RELEASE
BLOCK RELEASE
(non-consecutive days)
(consecutive days)
SECTION THREE: TRAVEL AND ACCOMMODATION DETAILS
This section applies to travel between the CURRENT PERMANENT RESIDENTIAL ADDRESS (Q 1.6) and training organisation.
Note: Travel between the temporary accommodation address stated in Q 3.5 and the training venue cannot be claimed under the Travel and
Accommodation Allowance Policy.
3.1
Mode of transport (please tick):
Private vehicle
Bus/rail
Air
If air is the mode of transport the apprentice/trainee may be paid a $20.00 Airport Transfer Subsidy (receipt required).
3.2
If you paid for public transport, the total ticket cost/s claimed is:
$
Copies of tickets or itineraries showing the amount claimed must be attached if you travel outside the metro area or your local
area.
3.3
Private transport may only be claimed by the owner/driver of the vehicle. Reg N#:
If claiming for private transport, are you, or a member of your family, the owner/driver?
If YES, what is the registration number of the vehicle?
YES
NO
3.4
Travel log — compulsory for all claims
Please enter dates and tick boxes/circle where applicable in the log below. Another page may
be attached if more room is required.
Training days = days attended off-the-job training (usually Monday to Friday).
Non training days = weekends, public holidays and travel days immediately prior to or after the training block.
Date
Please circle
type of day
Travelled
from home
Travelled
to home
Accommodation
claimed
Day 1
...................................................
Training
Non Training ................................
.............................
..................................
Day 2
...................................................
Training
Non Training ................................
.............................
..................................
Day 3
...................................................
Training
Non Training ................................
.............................
..................................
Day 4
...................................................
Training
Non Training ................................
.............................
..................................
Day 5
...................................................
Training
Non Training ................................
.............................
..................................
Day 6
...................................................
Training
Non Training ................................
.............................
..................................
Day 7
...................................................
Training
Non Training ................................
.............................
..................................
Day 8
...................................................
Training
Non Training ................................
.............................
..................................
Day 9
...................................................
Training
Non Training ................................
.............................
..................................
Day 10
...................................................
Training
Non Training ................................
.............................
..................................
Day 11
...................................................
Training
Non Training ................................
.............................
..................................
Day 12
...................................................
Training
Non Training ................................
.............................
..................................
Day 13
...................................................
Training
Non Training ................................
.............................
..................................
Day 14
...................................................
Training
Non Training ................................
.............................
..................................
Day 15
...................................................
Training
Non Training ................................
.............................
..................................
Day 16
...................................................
Training
Non Training ................................
.............................
..................................
Day 17
...................................................
Training
Non Training ................................
.............................
..................................
Day 18
...................................................
Training
Non Training ................................
.............................
..................................
Day 19
...................................................
Training
Non Training ................................
.............................
..................................
Day 20
...................................................
Training
Non Training ................................
.............................
..................................
Day 21
...................................................
Training
Non Training ................................
.............................
..................................
Day 22
...................................................
Training
Non Training ................................
.............................
..................................
Day 23
...................................................
Training
Non Training ................................
.............................
..................................
Day 24
...................................................
Training
Non Training ................................
.............................
..................................
Day 25
...................................................
Training
Non Training ................................
.............................
..................................
Day 26
...................................................
Training
Non Training ................................
.............................
..................................
Day 27
...................................................
Training
Non Training ................................
.............................
..................................
Day 28
...................................................
Training
Non Training ................................
.............................
..................................
Day 29
...................................................
Training
Non Training ................................
.............................
..................................
Day 30
...................................................
Training
Non Training ................................
.............................
..................................
Total number of trips travelled to training (only relates to those claims claiming travel allowance)
Total number of trips travelled home (only relates to those claims eligible for travel allowance but not claiming
accommodation)
Total number of accommodation nights (only relates to those claims where section 3.5 below is completed)
3.5
If you are claiming an accommodation allowance please provide the full temporary residential address
Street address:
Suburb/town:
Postcode:
SECTION FOUR: ACCOUNT DETAILS AND APPRENTICE/TRAINEE DECLARATION
This section is compulsory for all apprentices/trainees claiming the Travel and Accommodation Allowance Payment
for approved claims is issued by Electronic Funds Transfer (EFT) directly into the bank account listed below.
Cheques will not be issued.
4.1
Apprentice/trainee bank details. (Please print clearly)
Account holder name:
Bank:
Branch:
BSB number:
—
Account number:
(If no claim previously paid or bank details have changed please provide a copy of the top part of your bank statement showing
BSB and account number)
4.2
Apprentice / trainee declaration
I authorise the Department of Training and Workforce Development to pay any travel or accommodation
allowance into my bank account.
I certify that all of the details stated on this form, as provided by me, are true and correct. I understand
that it is a serious offence under the Criminal Code Act 1913 to provide a false and misleading statement
to gain entitlement to Travel and Accommodation Allowance.
___________________________________________________________________
Signature of apprentice/trainee
_________/_________/_________
Date
PLEASE USE AN ORGANISATION STAMP TO AUTHENTICATE THE ATTENDANCE DATES PROVIDED BELOW
SECTION FIVE. ATTENDANCE AND REGISTERED TRAINING ORGANISATION TO CERTIFICATION
5.1
During the period of claim (Q 2.3), state the number of
days the apprentice/trainee attended off-the-job training:
Number of authorised absences in same period
5.2
I certify the above details are correct and in accordance with Registered Training Organisation attendance
records.
_______________________________________________________________________
Signature of lecturer / authorised registered training organisation Officer
________________________________________________________________________
Name of lecturer / authorised registered training organisation officer
Please Print
_________/_________/_________
Date
(Form must not be signed by the lecturer before the end of the training period)
Travel and Accommodation Allowance
Guidelines for Apprentices / Trainees
Full guidelines can be found in the Travel and Accommodation Allowance Policy, apprenticentre.wa.gov.au.
You may be eligible for travel and/or accommodation allowance if you:
•
•
•
travel to off-the-job training that is funded by the Department of Training and Workforce Development
— if you don’t know if your training is funded by the Department ask your employer or telephone
ApprentiCentre on 13 19 54
listed on the Department’s system as an active, suspended or out of contract apprentice or trainee
during the claimed period
have a home address within Western Australia.
You may not be eligible for travel and/or accommodation allowance if you:
•
•
•
•
have a training status which is withdrawn, cancelled, completed, pending or expired at the time the
approved training was undertaken
are paid a Travel and Accommodation Allowance by your employer while attending training
have an employer who incurs the total cost of your travel and accommodation
travel to a registered training provider which is not the closest training venue approved to deliver off-thejob training.
Travel distances and eligibility
There is a minimum round trip distance which must be travelled to claim assistance. This is calculated based on
the shortest possible road distance from your usual place of residence to the closest training venue and return.
The minimum road trip distance must be at least:
• 71 kilometres for travel allowance
•
200 kilometres for accommodation allowance
1200 kilometres for travel by air.
Note that if you travel in the same vehicle as another trainee/apprentice — only one person can claim the travel
component of the allowance
•
Definition of closest training provider
The closest training provider is the one that has a training venue located the shortest possible road distance
from the apprentice’s/trainee’s residential address (regardless of the method of transport used to get to the
training venue).
Checklist:
Have you signed your claim form?
Has your lecturer signed your claim form?
Are the dates in the travel log consistent with the days the lecturer has signed off? (You may extend your
stay in the training location for personal reasons, providing there are no additional costs in the claim. You can not
claim extra accommodation when staying for personal related reasons.)
Are your bank details correct? (Remember your account number is the number on your bank statement, not the
number on your ATM card.)
Is relevant company documentations attached, e.g. travel and/or accommodation receipts?
Have you kept a copy of your claim?
Send your completed form to your nearest ApprentiCentre:
Post or fax your claim form to the ApprentiCentre closest to your home address
Goldfields
PO Box 10487
Kalgoorlie WA 6430
Fax (08) 9021 3405
Great Southern
228-232 Stirling Terrace
Albany WA 6330
Fax (08) 9841 8739
Perth
Travel and Accommodation Allowance
Department of Training and Workforce
Development
Locked Bag 16
Osborne Park Delivery Centre WA 6916
Fax: (08) 6551 5040
Midwest
PO Box 57
Geraldton WA 6531
Fax (08) 9921 3642
Kimberley
Apprenticentre – Kimberley Officer
Department of Training and Workforce
Development - Locked Bag 16
Osborne Park Delivery Centre WA 6916
Fax: (08) 6551 5040
Peel
PO BOX 1113
Mandurah WA 6210
Fax: (08) 9535 7109
Pilbara
Apprenticentre – Pilbara Officer
Department of Training and Workforce
Development - Locked Bag 16
Osborne Park Delivery Centre WA 6916
Fax: (08) 6551 5040
South West
Podium 61 Victoria Street
Bunbury WA 6230
Fax: (08) 9791 1448
Wheatbelt
PO Box 632
Northam WA 6401
Fax: (08) 9622 3299
For queries regarding the Travel and Accommodation Allowance please telephone ApprentiCentre on 13 19 54 or email
[email protected]