Sfn 52785 - Travel Expense Voucher
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3TRAVEL EXPENSE VOUCHER
STATE OF NORTH DAKOTA
SFN 52785 (03-2015)
Month
Year
Department Name
Official Position
Employee Name
Employee ID
Business Unit
Fiscal Month
Biennium
Hour
R
Comm'l
R
Taxi &
R
Meals
R
Lodging
(Show AM or PM)
Misc.
Meals
Lodging
Air
Other Air
Out of
Out of
Vehicle
e
e
e
e
Day Points Covered By Travel
Exp.
In State
In State
Trans.
Trans.
State
State
Depart
Arrive
Miles
f
f
f
f
Purpose of Travel and Explanation of Expenses:
Lodg. in State
521015
Lodg. out of State
521075
Meals in State
521020
Meals out of State
521080
IRS Meals-
Taxable
521035
Miscellaneous Expenses
Other Transportation in State
521025
Other Transportation out of State
521085
Air Transportation in State
521010
Air Transportation out of State
521070
X
Vehicle Miles in State
521030
X
Vehicle Miles out of State
521090
Total Expenses
(Ref. Doc. No. of Advance):
Less Travel Advance
NET EXPENSES
Dept.
Oper.
Resource
Resource
Line
Due Date
Account
Class
Fund
Project ID
Activity ID
Amount
ID
Unit
Type
Category
I hereby certify that the within itemized statement representing a claim for payment or per diem, mileage or travel expenses or a
TOTAL
combination thereof, truthfully and accurately states the days of service and the mileage traveled, and the purpose thereof.
Employee Signature
Date
Departmental Approval
Date
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