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["Safeguarders Panel \nFees and Expenses Claim Form"]
[]
[null,"Safeguarder name \nBy completing this box you are certifying that all claims included on this form are a true record in line with the Policy on Safeguarders Fees, Expenses & Allowances"]
[null,"SCRA ref number/s  if applicable"]
[null,"Date form completed"]
[null,"Please confirm whether claim is interim or final",null,null,"Please select from dropdown list"]
[null,"If final, please confirm date case concluded"]
[null,"Fee Claim Details"]
[null,"Date","Fee Description",null,null,null,null,"Amount"]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C10,'List of fees'!$A$4:$B$31,2,K8)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C11,'List of fees'!$A$4:$B$31,2,K9)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C12,'List of fees'!$A$4:$B$31,2,K10)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C13,'List of fees'!$A$4:$B$31,2,K11)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C14,'List of fees'!$A$4:$B$31,2,K12)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C15,'List of fees'!$A$4:$B$31,2,K13)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C16,'List of fees'!$A$4:$B$31,2,K14)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C17,'List of fees'!$A$4:$B$31,2,K15)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C18,'List of fees'!$A$4:$B$31,2,K16)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C19,'List of fees'!$A$4:$B$31,2,K17)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C20,'List of fees'!$A$4:$B$31,2,K18)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C21,'List of fees'!$A$4:$B$31,2,K19)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C22,'List of fees'!$A$4:$B$31,2,K20)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C23,'List of fees'!$A$4:$B$31,2,K21)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C24,'List of fees'!$A$4:$B$31,2,K22)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C25,'List of fees'!$A$4:$B$31,2,K23)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C26,'List of fees'!$A$4:$B$31,2,K24)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C27,'List of fees'!$A$4:$B$31,2,K25)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C28,'List of fees'!$A$4:$B$31,2,K26)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C29,'List of fees'!$A$4:$B$31,2,K27)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C30,'List of fees'!$A$4:$B$31,2,K28)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C31,'List of fees'!$A$4:$B$31,2,K29)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C32,'List of fees'!$A$4:$B$31,2,K30)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C33,'List of fees'!$A$4:$B$31,2,K31)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C34,'List of fees'!$A$4:$B$31,2,K32)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C35,'List of fees'!$A$4:$B$31,2,K33)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C36,'List of fees'!$A$4:$B$31,2,K34)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C37,'List of fees'!$A$4:$B$31,2,K35)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C38,'List of fees'!$A$4:$B$31,2,K36)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C39,'List of fees'!$A$4:$B$31,2,K37)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C40,'List of fees'!$A$4:$B$31,2,K38)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C41,'List of fees'!$A$4:$B$31,2,K39)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C42,'List of fees'!$A$4:$B$31,2,K40)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C43,'List of fees'!$A$4:$B$31,2,K41)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C44,'List of fees'!$A$4:$B$31,2,K42)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C45,'List of fees'!$A$4:$B$31,2,K43)","v":0}]
[null,null,"Please select from drop down list",null,null,null,null,{"$f":"VLOOKUP(C46,'List of fees'!$A$4:$B$31,2,K44)","v":0}]
[null,"Total Fees",null,null,null,null,null,{"$f":"SUM(H10:H46)","v":0}]
[]
[null,"Expenses Incurred \ne.g. travel, accommodation & parking costs. Use separate line for each expense/receipt"]
[null,"Date","Type of Expenditure",null,"Purpose of Expenditure",null,"Receipt (Y/N)","Amount"]
[null,null,"Please select from drop down list"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"Total Expenses",null,null,null,null,null,{"$f":"SUM(H51:H70)","v":0}]
[null,"Administrative Costs \nFor use only for cases where overall admin spend greater than £10"]
[null,"Date","Type of Expenditure",null,"Purpose of Expenditure",null,"Receipt (Y/N)","Amount"]
[]
[]
[]
[]
[]
[null,"Admin Costs Subtotal",null,null,null,null,null,{"$f":"SUM(H74:H78)","v":0}]
[null,"Less first £10 of admin costs (covered by fixed appointment fee)",null,null,null,null,null,-10]
[null,"Total Admin Costs",null,null,null,null,null,{"$f":"IF(H79>10,H79-10,IF(H79<10,0))","v":0}]
[null,"Mileage"]
[null,"Date","From","To","Purpose of Journey","Miles","Rate","Amount"]
[null,null,null,null,null,null,0.45,{"$f":"F84*G84","v":0}]
[null,null,null,null,null,null,0.45,{"$f":"F85*G85","v":0}]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0,null,null,null,null,null,{"$f":"IF(OR(B79>10),\"\")","v":""}]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,null,null,null,null,null,0.45,0]
[null,"Total Mileage",null,null,null,null,null,{"$f":"SUM(H84:H100)","v":0}]
[]
[null,"Total Amount Due",null,null,null,null,null,{"$f":"H47+H71+H81+H101","v":0}]
[]
[null,"Please email completed claim form to safeguarderspanel@childrenfirst.org.uk"]

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["Drop down lists"]
[]
["Fee Type","Rate"]
["Please select from drop down list",0]
["Children's Hearing - Fixed appointment fee (including report)",286.75]
["Children's Hearing - Fixed additional appointment fee for second & each subsequent child living separately",215]
["Children's Hearing - Fixed additional appointment fee for second & each subsequent child living together",143.5]
["Children's Hearing - Daily fixed attendance fee",143.25]
["Children's Hearing - Fixed fee for additional work",71.75]
["Children's Hearing - Fixed additional work fee for second & each subsequent child living separately",37.5]
["Children's Hearing - Fixed additional work fee for second & each subsequent child living together",18.75]
["Children's Hearing - Fixed fee for additional written report if required",143.25]
["Children's Hearing - Fixed fee for additional written report for second & each subsequent child",71.75]
["Children's Hearing - Fixed fee for oral report if required",71.75]
["Children's Hearing - Daily fixed attendance fee - Pre Hearing Panel",71.75]
["Children's Hearing - Fixed fee for additional work - Pre Hearing Panel",37.5]
["Children's Hearing - Fixed additional work fee for second & each subsequent child living separately - Pre Hearing Panel",18.75]
["Children's Hearing - Fixed additional work fee for second & each subsequent child living together - Pre Hearing Panel",10]
["Children's Hearing - Fixed fee for additional written report if required - Pre Hearing Panel",37.5]
["Children's Hearing - Fixed fee for oral report if required - Pre Hearing Panel ",18.75]
["Court Proceedings - Fixed appointment fee",286.75]
["Court Proceedings - Fixed additional appointment fee for second & each subsequent child living separately",143.25]
["Court Proceedings - Fixed additional appointment fee for second & each subsequent child living together",71.75]
["Court Proceedings - Fixed appointment fee when NOT entering proceedings",71.75]
["Court Proceedings - Fixed additional appointment fee for second & each subsequent child when NOT entering proceedings",37.5]
["Court Proceedings - Daily fixed attendance fee",143.25]
["Court Proceedings - Fixed fee for additional work",71.75]
["Court Proceedings - Fixed additional work fee for second & each subsequent child living separately",37.5]
["Court Proceedings - Fixed additional work fee for second & each subsequent child living together",18.75]
["Court Proceedings - Fixed fee for written report where requested by the Sheriff (following initial appearance)",143.25]
["Court Proceedings - Fixed fee for written report submitted when the safeguarder cannot attend a court hearing",143.25]
[]
["Expenses"]
["Please select from drop down list"]
["Bed & Breakfast"]
["Car Hire"]
["Car Parking"]
["ICO Registration"]
["Meals Allowance"]
["Miscellaneous"]
["Personal Incidental Expenses Allowance"]
["Public Transport - Air"]
["Public Transport - Bus"]
["Public Transport - Ferry"]
["Public Transport - Rail"]
["Public Transport - Taxi"]
["Staying with Friends"]
["Toll charges"]
["Other"]
[]
["Administrative costs"]
["Postage"]
["Telephone calls"]
["Stationery"]
[]
[]
["Mileage Rates"]
["Car Mileage Rate",0.45]
["Motor Cycle Allowance",0.24]
["Pedal Cycle Allowance",0.2]
["Passenger Supplement",0.05]