Full Name

Pay Reference No

Post Title

Vehicle Registration

Establishment Name

Appointment Date

Cost Centre Code

Change effective date

Allowance Details

Tick if Applicable

Casual

Essential

Lease Car

Other*

Authorised Officer Signature

Print Name

Date

Payroll Authorisation

The accuracy of the above details is the responsibility of the authorising officer or Unit Manager.

This form should be completed on issue of a new contract to the employee or for any amendments that will affect travelling entitlements. It should be passed to ITNET Services in a sealed envelope marked 'Travelling system input documents'.

HR Recruitment Team, John Dryden House