STATEMENT OF EXPENSES & HONORARIA

Please submit one form per meeting.
For example, if you have submissions for a Council meeting and a Registration Exam meeting and a Quality Assurance meeting, please submit three forms.

Review the Per Diems and Council and Committee Compensation & Expense Policy.

Name of Member:

Position:

Committee this submission is associated with:
(Submit one expense form per meeting)

Your email:

PER DIEM / HONORARIA

For breakdown please see Per Diem Rates Paid By the College at the top-right of this page.

	Date	Meeting Length	Purpose	Amount
1.
2.
3.
			Total $

TRAVEL EXPENSES

Private Car - Please select "Return Trip" and extend sub total if claiming for a round trip.

	Date	From / To	# KM's x $0.50 / Return Trip	Amount
1.			Return Trip? Yes
2.			Return Trip? Yes
3.			Return Trip? Yes
			Total $

Parking- Receipts must be attached.

	From / To	Receipts File
1.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
2.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
3.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
	Total $

Travel by Public Transit (train, air, bus, subway, etc.) - Receipts must be attached (except for local bus, streetcar and subway).

Please select "Return Trip" and extend subtotal if claiming for a round trip.

	From / To Return Trip	Receipts File
1.	Return Trip? Yes	Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
2.	Return Trip? Yes	Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
3.	Return Trip? Yes	Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
	Total $

Travel Time

This amount is in addition to actual travel expenses. Travel time per diem claims must be included with the expense claim and are payable to all registrants on College business as follows:

a. For travel of more than 40 kilometers (one way), a quarter day per diem is payable;
b. For travel of more than 500 km (return trip), a per diem of $125 is paid for extended travel time.

	Date	Amount
1.
2.
3.
		Total $

MEALS

Maximum allowance is $10 for breakfast, $15 for lunch, $30 for dinner. Claims for meals should not be made for virtual meetings/hearings (i.e. Zoom).

	Date	Particulars	Amount
1.
2.
3.
		Total $

ACCOMMODATION

Members who require overnight accommodation in the City of Toronto must book a room at the DoubleTree Hilton, 108 Chestnut St, Toronto, ON M5G 1R3, where the College has preferred rates:

• $219/night during low season – January, February, March, November and December
• $239/night during high season – all other months

Receipts must be attached for hotels.

	Meeting	Receipts File
1.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
2.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
3.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
	Total $

MISCELLANEOUS EXPENSES

Office Supplies, telephone calls, fax charges, etc.; receipts must be attached.

	Particulars	Receipt Files
1.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
2.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
3.		Accepted file types: .PDF, .GIF, PNG,.JPG,.JPEG
	Total $

Total Amount Claimed $

DECLARATION

This is to certify that the above expenses / honoraria were incurred by me / are due to me for the above stated period. While using my personally owned vehicle as shown, the vehicle insurance permitted its use for business purposes.

Claimant's Name:

Date:

Please note: Word files (.doc .docx) files are not accepted for uploads and depending on file attachments the upload may take a a bit of time. You will get a message when complete. Total size of all attachments cannot exceed 25MB combined as per most mail server rules.

Per Diem Rates Paid By the College

President or Committee Chair
Full day (6+ hrs) = $350
3/4 day (4-5 hrs) = $262.50
1/2 day (2-4 hrs) = $175
1/4 day (< 2 hrs) = $87.50

Vice-President
Full day (6+ hrs) = $325
3/4 day (4-5 hrs) = $243.75
1/2 day (2-4 hrs) = $162.50
1/4 day (< 2 hrs) = $81.25

Member
Full day (6+ hrs) = $300
3/4 day (4-5 hrs) = $225
1/2 day (2-4 hrs) = $150
1/4 day (< 2 hrs) = $75

Mentorship
Visit = $400
Written Report = $400

Practice Assessment
Practice Assessment & Written Report = $475