Travel Expense Form
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1Greater Pittsburgh Intergroup of OA
PO Box 5459 Pittsburgh, PA 15206
Travel Expense Form
Name: _______________________________________________________________________
Date of Trip: __________________________________________________________________
Destination: __________________________________________________________________
Transportation
Mode of Transportation: ___________________________________________________
Airfare: _________________________________________________________________
Car Rental: ______________________________________________________________
Tolls: __________________________________________________________________
Mileage at $0.34 (IRS charitable rate + $0.20) (if applicable): ______________________
Gasoline: _______________________________________________________________
PLEASE NOTE: GPI WILL REIMBURSE MILEAGE *OR* GASOLINE, NOT BOTH
Total Transportation $______________
Lodging
_____ Nights @ $__________
Total Lodging $____________________
Meals
Date
Breakfast
Lunch
Dinner
Other
Total
______
$_______
$______
$______
$______
$_____
______
$_______
$______
$______
$______
$_____
______
$_______
$______
$______
$______
$_____
______
$_______
$______
$______
$______
$_____
______
$_______
$______
$______
$______
$_____
______
$_______
$______
$______
$______
$_____
Total Meals $__________
TOTAL TRAVEL EXPENSES $__________
Check #: _______ Budget Category or Categories________________________________________
Revised October 2015
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