Fair Pay Services Expense Claim Form

This form is used to support claims made to your Agency for approved expenses to be reimbursed.

Please complete a separate form for each expense being claimed if you have multiple expenses. Once submitted the form will be processed in your next payroll once funds are received from your Agency.

  • Expense Claim

Expense Details

Nights of the week claimed where required for your job

Add a 2nd journey

Add a 3rd journey

Add a 4th journey

Add a 5th journey

Please upload any supporting evidence / receipts

Max. size: 50.0 MB

If you do not have the receipt available at this time please upload onto your personal Flexr portal.

I hereby declare that all expenses claimed for by me on the above dates have been incurred wholly, exclusively and necessarily for the purpose of my employment and during the course of an Assignment for yourselves. The expenses claimed on these dates have not and will not be claimed against any other company.




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Call us on 01604 360222

Opening Hours
9:00am - 5:30pm Monday - Friday
Registrations Team (Option 1)
registerme@fairpayservices.co.uk
Contractor Care Team (Option 2)
helpme@fairpayservices.co.uk
Vulcan Works, 34-38 Guildhall Road, Northampton, Northamptonshire, NN1 1EW