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Mileage Reimbursement Form (Canada)

Mileage Reimbursement Form (Canada)

CLAIMANT INFORMATION

Name: [Claimant Name]

Address: [Claimant Address], [Claimant City], [Claimant Province] [Claimant Postal Code]

Email: [Claimant Email]

ORGANIZATION

[Organization Name]

[Organization Address], [Organization City], [Organization Province] [Organization Postal Code]

Phone: [Organization Phone]

TRIP DETAILS

Purpose: [Trip Purpose]

Destination: [Trip Destination]

Date of trip: [Trip Date]

Vehicle used: [Vehicle Description]

MILEAGE CALCULATION

Total kilometres driven: [Total Kilometres] km

Rate per kilometre: CAD $[Rate Per Km]

Total mileage reimbursement: CAD $[Mileage Amount]

Note: The Canada Revenue Agency (CRA) prescribed kilometric rate for 2026 is $0.73 per kilometre for the first 5,000 business kilometres and $0.67 per kilometre thereafter. For travel in the Yukon, Northwest Territories, and Nunavut, the rates are $0.77 and $0.71 respectively. Reimbursement at or below the CRA rate is not considered a taxable benefit under the Income Tax Act (R.S.C. 1985, c. 1 (5th Supp.)).

CERTIFICATION

I, [Claimant Name], certify that the mileage and expenses claimed above were incurred for legitimate business purposes on behalf of [Organization Name] and that the information provided is accurate and complete to the best of my knowledge. I understand that submitting a false or fraudulent claim may result in disciplinary action or dismissal. Receipts for tolls, parking, and other expenses are attached where available.

Claimant’s Signature: ____________________

Name: [Claimant Name]

Date: [Signing Date]

SUPERVISOR APPROVAL

I, [Supervisor Name], [Supervisor Title], hereby approve this mileage reimbursement claim for payment.

Supervisor’s Signature: ____________________

Name: [Supervisor Name]

Title: [Supervisor Title]

Email: [Supervisor Email]

Date: ____________________

This mileage reimbursement is governed by the laws of the Province of [Governing Province] and the applicable federal laws of Canada, including the Income Tax Act (R.S.C. 1985, c. 1 (5th Supp.)) and the CRA prescribed kilometric rates. Automobile allowances paid at or below the CRA prescribed rates based solely on business kilometres driven are not considered a taxable benefit under paragraph 6(1)(b) of the Income Tax Act.

Claimant

________________

Signature

Date: ________________

Supervisor

________________

Signature

Date: ________________

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Mileage Reimbursement Form (Canada)?

A Mileage Reimbursement Form in Canada records an employee’s business mileage and the reimbursement claimed for it, governed primarily by provincial employment legislation and the Income Tax Act.

The Canada Revenue Agency (CRA) publishes prescribed per-kilometre rates annually under the Income Tax Act (R.S.C., 1985, c. 1 (5th Supp.)) and its regulations. For 2024, the CRA kilometric rate is $0.70/km for the first 5,000 km driven for employment purposes and $0.64/km for each additional kilometre (higher rates apply for the Yukon, Northwest Territories, and Nunavut). Employers who reimburse at or below the CRA prescribed rate are not required to include the reimbursement in the employee's income for tax purposes. Reimbursements exceeding the CRA rate are a taxable benefit that must be reported on the employee's T4 slip.

For self-employed individuals, the Income Tax Act (ITA) allows deduction of vehicle expenses (including a per-kilometre calculation or actual expense method) to the extent the vehicle is used to earn business income. The CRA requires a mileage log to substantiate vehicle expense claims on T1 (individual) or T2 (corporate) tax returns, referencing its guidance in Interpretation Bulletins IT-521R and IT-522R.

The legal framework governing the Mileage Reimbursement Form (Canada) in Canada draws on several key statutes and regulatory bodies. Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Parties executing a Mileage Reimbursement Form (Canada) in Canada should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Canada Labour Code (R.S.C. 1985, c. L-2) sets the foundational requirements.

When Do You Need a Mileage Reimbursement Form (Canada)?

A mileage reimbursement form is needed whenever an employee, contractor, or volunteer uses their personal vehicle for work-related travel and wants to be reimbursed by their employer or organization. Common use cases include sales representatives visiting clients across a territory, home care workers traveling between client residences, field inspectors visiting project sites, social workers conducting home visits, and volunteers using personal vehicles for charity work.

For payroll and accounting purposes, employers need documented mileage claims to process reimbursements as non-taxable employment expense reimbursements (at or below CRA rates), rather than as taxable employment income. The CRA may audit employer vehicle reimbursement programs, and accurate mileage records are essential to demonstrate compliance with the Income Tax Act.

For government employees, the National Joint Council's Travel Directive sets mileage reimbursement rates for federal employees. Provincial government employees are covered by equivalent provincial travel directives, and each requires a completed mileage claim form as the basis for reimbursement.

For non-profit organizations and registered charities, volunteer mileage reimbursement at CRA rates does not constitute a taxable benefit to volunteers. Without completed mileage forms, organizations cannot justify reimbursements as legitimate expense claims in their financial statements or under CRA audit. Self-employed individuals also use mileage records to support the business-use percentage of vehicle expenses claimed on their T1 income tax returns.

Parties in Canada should prepare a Mileage Reimbursement Form (Canada) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

What to Include in Your Mileage Reimbursement Form (Canada)

A compliant Canadian Mileage Reimbursement Form must include the claimant's full legal name, address, and contact information. The form must identify the employer or organization that will process the reimbursement, including the organization's name, address, and contact details. This information is necessary for the organization's accounting records and for the CRA in the event of an audit.

The trip details section must record the date of each business trip, the destination address, and the business purpose of the travel. The CRA requires that the purpose be specific and business-related, not a generic description. The total kilometres driven for each trip must be recorded, preferably with starting and ending odometer readings. The per-kilometre rate used for the calculation must be stated, whether it is the CRA prescribed kilometric rate or an employer-approved rate. The total reimbursement amount is calculated as the total kilometres multiplied by the applicable rate, in Canadian dollars (CAD).

Additional expenses such as toll charges, parking fees, and ferry charges may be claimed separately and should be supported by receipts. These expenses are reimbursed at actual cost and are not subject to the per-kilometre rate. The vehicle used for business travel should be identified by year, make, model, and licence plate number, particularly if the employee uses multiple vehicles or if the organization requires vehicle identification for insurance or liability purposes.

The form must include a certification clause in which the claimant affirms that the mileage and expenses were incurred for legitimate business purposes and that the information is accurate and complete. A supervisor approval section provides for the authorizing manager's name, title, signature, and date, confirming that the claim has been reviewed and approved for payment. The form should reference the CRA prescribed kilometric rates and the applicable provisions of the Income Tax Act. The governing province should be identified for provincial tax and employment standards purposes.

Additional compliance elements for a Mileage Reimbursement Form (Canada) used in Canada include: Under the Canada Labour Code (R.S.C. 1985, c. L-2), the Canada Industrial Relations Board adjudicates federal workplace disputes. Provincial employment standards legislation — including Ontario's Employment Standards Act 2000 and British Columbia's Employment Standards Act (RSBC 1996) — governs minimum employment terms. The Personal Information Protection and Electronic Documents Act (PIPEDA) governs private-sector data handling. The Canada Revenue Agency (CRA) administers source deductions and Canada Pension Plan (CPP) contributions. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.

Sources & Citations

Statutory citations link to official government sources.

  1. R.S.C. 1985, c. L-2CA official

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Mileage Reimbursement Form (Canada) (Canada) [Legal document template]. Forms Legal. https://forms-legal.com/canada/employment/hr-forms/mileage-reimbursement-form-canada

MLA

"Mileage Reimbursement Form (Canada) (Canada)." Forms Legal, 2026, https://forms-legal.com/canada/employment/hr-forms/mileage-reimbursement-form-canada.

BibTeX
@misc{formslegal-mileage-reimbursement-form-canada,
  author       = {{Forms Legal}},
  title        = {Mileage Reimbursement Form (Canada) (Canada)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/canada/employment/hr-forms/mileage-reimbursement-form-canada}},
  note         = {Free legal document template. Based on Canada Labour Code (R.S.C. 1985, c. L-2)}
}

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Frequently Asked Questions

Based on Canada Labour Code (R.S.C. 1985, c. L-2) — Template last modified June 2026Verify the source →

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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