Professional / Medical Witness Reimbursement Claim For Attendance at Coroner’s Inquest

I attended the below inquest at the request of HM Coroner as a Professional / Medical witness on my normal working day. I wish to claim the following expenses in addition to my fee set by the Home Office for giving evidence.

Personal Details

Name of person claiming

Start / home address (including post code)

End Address

Occupation

Email address (for remittance advice slips)

Daytime contact telephone number

Date(s) of inquest

Name of deceased (if relevant)

Time in court

Day	Time of Arrival	Time of Departure
Day One	Time of arrival	Time of departure
Day Two	Time of arrival	Time of departure
Day Three	Time of arrival	Time of departure
Day Four	Time of arrival	Time of departure
Day Five	Time of arrival	Time of departure

Salary / wage (letter required)

Number of hours claimed

Hourly rate

Travelling expenses (original receipt(s) required)

Mode of transport

Miles claimed

Public transport / taxi fares claimed

Car parking claimed

Other expenses (Having the approval of HM Coroner prior to the expenses being incurred)

Total time absent from work to attend inquest

Subsistence (original receipt(s) required)

Please detail the total amount being claimed for

Bank Details

Name and address of Building Society/Bank

Account in the name of

Account number

Sort Code

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