Form 25t 2025

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4.8 out of 5

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The document is an Itemized Statement of Charges for Travel related to workers' compensation in North Carolina. It outlines the reimbursement process for employees traveling for medical treatment, detailing eligible expenses such as mileage, lodging, meals, and other costs. Employees can claim $0.58 per mile for trips over 20 miles roundtrip, with specific guidelines on what expenses are reimbursable. The form must be submitted to the employer or insurance carrier for payment.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Employee Code, Carrier Code, and Carrier File number at the top of the form. This information is essential for processing your claim.
Fill in your Employer FEIN, followed by your name and address details. Ensure accuracy to avoid delays in reimbursement.
In the section for travel expenses, list the date of travel and the name of the medical provider visited. Be sure to include total miles traveled roundtrip.
Detail any other expenses incurred during travel, such as motel stays or meals. Remember to attach receipts for verification.
Finally, certify your expenses by signing at the bottom of the form. Make sure to send a duplicate copy to your employer or insurance carrier promptly.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (235 Votes)
2013	4.4 Satisfied (546 Votes)
2011	4 Satisfied (60 Votes)
2010	4 Satisfied (60 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the minimum a company can pay for mileage?

What is the mileage rate? The HMRC-approved mileage rate for tax purposes is 45p per mile for cars and vans, for up to 10,000 miles of work-related driving. Above 10,000 miles the approved mileage rate is 25p per mile for cars and vans. The rate for motorcycles and bikes is 24p and 20p, respectively.

What is a form 26A in NC?

To provide relief in such cases, the government has introduced Form 26A, which allows deductors to docHub that the payee has already included the income in their return and paid the necessary taxes. This form acts as a safeguard against disallowance under Section 201(1) and Section 40(a)(ia).

Does NC require mileage reimbursement?

While North Carolina doesnt have specific laws that require you, as a private employer, to reimburse mileage to your employees, adhering to the IRS standard rate and reimbursing is a very smart business move.

What is the mileage reimbursement law in NC?

11 N.C. Admin. Code 23L . 0103 - FORM 26A - EMPLOYERS ADMISSION OF EMPLOYEES RIGHT TO PERMANENT PARTIAL DISABILITY | State Regulations | US Law | LII / Legal Information Institute.

What does my company have to pay me for mileage?

The 2024 mileage reimbursement rate for business miles is 67 cents per mile, 21 cents for medical and moving miles, and 14 cents for miles in the service of charitable organizations.