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Medical Mileage Expense Form - California (English / Spanish)
Medical Mileage Expense Form is a legal document that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California.
FAQ
Q: What is the purpose of the Medical Mileage Expense Form?
A: The form is used to claim reimbursement for medical travel expenses.
Q: Who is eligible to use the Medical Mileage Expense Form?
A: California residents who have incurred travel expenses for medical purposes.
Q: Is this form available in both English and Spanish?
A: Yes, the form is available in both English and Spanish versions.
Q: What information is required to fill out the form?
A: You will need to provide details such as your personal information, the purpose of the travel, and the mileage you have traveled.
Q: Are there any supporting documents required with the form?
A: Yes, you will need to attach copies of your travel receipts and any other relevant documents.
Form Details:
- Released on June 1, 2022;
- The latest edition currently provided by the California Department of Industrial Relations - Division of Workers' Compensation;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.
