Expense and mileage reimbursement form
Fill it in here, print it or save it as a PDF, and attach the receipts. Mileage uses the IRS rate for the day of each trip — 72.5¢ through June 30, 76¢ from July 1, 2026 — and everything totals itself. Nothing you type leaves this page or is saved, so print it before you close the tab.
What makes a reimbursement tax-free
Paid under an accountable plan, a reimbursement isn't income to the person reimbursed, and the business deducts it. The form is the record that makes that hold up. For each expense it needs the amount, the date, where it was, and the business purpose, with a receipt for lodging and for anything $75 or more. For mileage: the date, where you went, why, and the miles.
- Submit it promptly. Within 60 days of each expense is the IRS's safe harbor; monthly keeps you well inside it.
- Return any advance you didn't spend within 120 days.
- Have it approved and paid from the business's account, not settled in cash.
- Mileage at or below the IRS rate is tax-free with a log; anything paid above it is wages.
Who it's for
- Employees claiming back business costs from their employer.
- S corporation owners reimbursing themselves under their company's accountable plan — for phone, home office and car. The accountable plan template has the plan to adopt and a filled-in month.
- Small businesses that need a simple, consistent form for their team.
Sole proprietors don't reimburse themselves — they deduct these costs directly — but the mileage log here is the same record the IRS expects. The mileage calculator works out a year at once.
Whether a cost is reimbursable under your plan is a question for your employer, or for your CPA if it's your company.
Sources
- Treas. Reg. §1.62-2 — accountable plans: substantiation, the 60- and 120-day safe harbors
- Treas. Reg. §1.274-5 — receipts for lodging and for expenses of $75 or more
- Rev. Proc. 2019-46 and IRS Publication 463 — mileage allowances and logs
- IRS standard mileage rates — 72.5¢ through June 30, 76¢ from July 1, 2026
General information, not advice for your situation. Whether a strategy fits depends on your facts — talk to your CPA or tax attorney about whether you qualify before you put it in place. Your accountant remains responsible for your return.
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OpenYear reads your books, shows which strategies fit your business and why, and keeps the records each one needs — ready for your accountant. It's built for owner-operated S corporations.