Regular Car User Allowance Eligibility Assessment Form

REGULAR CAR USER ALLOWANCE ELIGIBILITY ASSESSMENT FORM

NAME: / EMPLOYEE No:
DEPARTMENT: / JOB TITLE:
CONTRACTED HOURS:
CURRENT ALLOWANCE TYPE: Regular/Essential
Occasional/Casual / SERVICE:
Assessment factors
(read accompanying note on mileage calculation via the following link before completing / Tick what is applicable
(only tick one box in each section) / Comments
1. Requirement to transport service users or pupils
Never required
Occasionally – on less than 25% of journeys
Regularly – but less than 50% of the journeys
Frequently – more than 50% of journeys
2. Call out
Never / rarely required to travel at short notice to respond to emergencies (less than twice per month) during normal office hours.
Occasionally required to travel at short notice to respond to emergencies (less than twice per month) outside normal office hours.
Regularly required to travel at short notice to respond to emergencies during normal office hours.
Regularly required to travel at short notice to respond to emergencies outside normal office hours.
3. Frequency of journeys
0 – 10 per month
10 to 20 per month
20 to 30 per month
30 and over
4. Business Mileage (actual business mileage for last 12 months or estimated mileage over 12 months if new starter)
Below 3000 miles
3000 miles– 4000 miles
4000 miles– 5000 miles
More than5000 miles
5. Requirement to carry heavy and / or bulky equipment
Never
Occasionally – on less than a quarter of journeys
Regularly – but less than half of the journeys
Frequently – more than half of journeys
6. Availability of alternative / suitable transport (e.g. public transport, pool cars, cycles, taxis, car sharing)
Available and suitable for 75% plus of journeys
Available and suitable for 50% to 75% of journeys
Available and suitable for less than 50% of journeys
7. Time of journeys undertaken
Journeys usually made during normal office hours
Occasional need to attend planned evening/weekend duties/meetings (less than twice a month)
Regular planned journeys at weekends/evenings (over 30% of journeys undertaken)
Further considerations
Disability
If the employee has special needs (as recognised by the Disability Discrimination Act) which cause, for example, especially higher costs in buying or running the car or which make use of alternative transport impractical. The degree of justification will depend on the extent of costs or alternatives. / Comments
Personal safety - assessment of the degree of risk in the journeys
If any employee is frequently required to travel in areas of the Borough where the personal safety of the employee could be especially at risk and where having a car available will reduce the degree of this risk (to the employee or passengers).
The degree of risk must take account, also, of the nature and value of equipment which may be carried. The higher the frequency or degree of risk, the greater likelihood that a regular user allowance could be justified in borderline cases. But again if a pool car is available and suitable this should be used and this should not justify a Regular User Allowance. / Comments
Any Additional Manager Comments:
Signed:Date:
Print Name:Job Title:
Please ensure that you return your completed assessment forms by 4 November 2011 to .
FOR HR USE:
Regular allowance is: AGREED / NOT AGREED