My Form History
Your latest 50 submissions and print previews from the past 30 days on this browser. New activity appears here after this update. This log does not sync across devices or show current AP approval/payment status. A print preview is not a submission or proof of printing.
Saved copies remain on this browser after sign-out and are separated by signed-in account. They are not encrypted. Clear this history on a shared computer; clearing browser data also removes it.
Mileage Reimbursement Request
Submit your mileage for work-related travel. Questions? AP@HCCTS.ORG
Mileage is based on the normally recommended Google Maps driving route between authorized locations. Necessary business-related adjustments require an explanation and are subject to AP review.
The requestor's typed staff signature is rendered as an electronic signature on the printed/PDF form. Supervisor, Director, and CAO/COO/ED approval lines remain available for approval signatures.
This form is saved in this browser for 30 days from the latest change. It is not synced, sent anywhere, or encrypted. Drafts are separated by signed-in account and removed when you sign out. Use "Discard saved draft" on a shared computer.