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SG Fleet Australia Pty Limited ABN 15 003 429 356 Building 3 Level 2 20 Bridge Street Pymble NSW 2073 Ph 1800 818 487 Fax 02 9391 5607 PO Box 252 Pymble NSW 2073 Email claims sgfleet. com NOVATED LEASE EXPENSE CLAIM FORM 1. Claimants Details - Please complete in full Full Name Company Name Phone Number Vehicle Registration Email Address Current ODO Reading As at / Home Address 2. SG Fleet Australia Pty Limited ABN 15 003 429 356 Building 3 Level 2 20 Bridge Street Pymble NSW 2073 Ph 1800 818 487 Fax 02 9391 5607 PO Box 252 Pymble NSW 2073 Email claims sgfleet. com NOVATED LEASE EXPENSE CLAIM FORM 1. Claimants Details - Please complete in full Full Name Company Name Phone Number Vehicle Registration Email Address Current ODO Reading As at / Home Address 2. Expense Reimbursements or Direct Payment - Please complete the appropriate sections below in full and tick the appropriate box. IMPORTANT- It is at all times the responsibility of the employee to ensure their motor vehicle is registered and comprehensively insured* All renewal papers for registration and comprehensive insurance are sent directly to the driver by the relevant parties. Registration Please Pay Supplier Direct Please Reimburse me via EFT C. T. P Insurance Auto Club Membership Comprehensive Insurance INFORMATION REQUIRED Copies only. Do not send original documents. Please send a copy of the following with this form If requesting direct payment please ensure supplier payment details are forwarded to sgfleet. 3. Other Running Cost Expense s - Please itemise REIMBURSEMENT ONLY Fuel Purchase/s Maintenance Other Vehicle Expenses the Tax Invoice and the amount paid* If your tax invoice does not show a GST portion for purchases over 82. 50 your sgfleet vehicle fund will be charged the full amount inclusive of GST if the purchase is under 82. 50 you will not be charge the GST portion* Your reimbursement will be processed on the condition you have sufficient funds in your sgfleet Vehicle Fund* 4. Declaration - I declare the attached invoices were properly incurred in the running and maintenance of my vehicle. I confirm where reimbursement has been requested that the expense has already been paid in full prior to this request. Clients Signature Date BEFORE SUBMITTING YOUR CLAIM PLEASE ENSURE YOU HAVE SUFFICIENT FUNDS YOUR CURRENT BANK DETAILS HAVE BEEN PROVIDED FOR REIMBURSEMENT Please visit our website www. com NOVATED LEASE EXPENSE CLAIM FORM 1. Claimants Details - Please complete in full Full Name Company Name Phone Number Vehicle Registration Email Address Current ODO Reading As at / Home Address 2. Expense Reimbursements or Direct Payment - Please complete the appropriate sections below in full and tick the appropriate box. Expense Reimbursements or Direct Payment - Please complete the appropriate sections below in full and tick the appropriate box. IMPORTANT- It is at all times the responsibility of the employee to ensure their motor vehicle is registered and comprehensively insured* All renewal papers for registration and comprehensive insurance are sent directly to the driver by the relevant parties. .

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