Travel Expense Form
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1HARRISON COUNTY, TEXAS
TRAVEL EXPENSE FORM NO. 2
NAME OF PERSON SUBMITTING REPORT:_______________________________________
NAME OF DEPARTMENT:______________________________________________________
DESTINATION:_______________DEPARTURE DATE:_______RETURN DATE:_________
MEALS: You may claim reimbursement for meals at the approved IRS Federal per diem rate so long
as no per diem advance was received. If no advance was received but you are requesting
reimbursement for meals, please attach a copy of the seminar or conference agenda to this form.
DATE
DAILY TOTAL
_________
______________
_________
______________
_________
______________
_________
______________
TOTAL (M&IE):
______________
$ 0.00
LODGING: Actual expenses for lodging will be paid. Receipts must be attached for reimbursement
to be paid.
DATES: TO:_________ FROM:_________
RATE PER DAY:______________________
TOTAL LODGING: ______________
TRAVEL AND TRANSPORTATION
**Airline, Bus, Train (Attach Travel Ticket Invoice)----____________
**Personal Auto ______Miles @ ___ cents Per Mile
(Shortest Route)------------------____________
**Other Travel or Transportation Expense (Attach
Receipts)-------------____________
$ 0.00
TOTAL TRAVEL: _______________
OTHER EXPENSES
**Conference Registration (Attach Receipt and Copy
of Conference Program)--------------------___________
TOTAL OTHER EXPENSES:______________
$ 0.00
TOTAL THIS TRAVEL EXPENSE FORM
_______________
$ 0.00
DEDUCT ADVANCE FROM FORM NO. 1
_______________
AMOUNT OF REIMBURSEMENT - OR - DUE TO COUNTY
_______________
------------------------------------------------------------------------------------------------------------------
CERTIFICATION BY EMPLOYEE: “I certify that the Expenses as shown on this form are true and
correct statements of expenses incurred by me while traveling on official county business.”
_______________________________________
Signature of Employee
CERTIFICATION OF ELECTED OFFICIAL OR DEPARTMENT HEAD: “I certify that the above
named employee received proper authorization for official county travel. I have examined the request
for reimbursement and recommend the same for payment.”
______________________________________
Signature of Official
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