Niddk Advisory Council Travel Expense Form printable pdf download

Niddk Advisory Council Travel Expense Form

NIDDK ADVISORY COUNCIL TRAVEL EXPENSE FORM

January 27, 2016 Meeting

REQUIRED RECEIPTS: (Please attach to this form)

• Travel Stubs/Itinerary with total price of ticket

$___________

• Original Hotel itemized receipt:

- Room Rate

$___________

- Hotel Taxes

- Phone Calls ($5.00 per day are reimbursable)

$___________

• Other travel-related receipts over $75.00

$___________

• Rental car (reimbursement must be pre-approved)

$___________

OTHER REIMBURSEABLE EXPENSES:

• Privately Owned Vehicle (Number of Miles x

cents)

$___________

0.55

• Parking Fees

$___________

• Taxis:

- From Residence to Terminal

$___________

- From Terminal to Hotel

$___________

- From NIH Campus to Terminal

$___________

- From Terminal to Residence

$___________

- Other

$___________

• Tolls

$___________

• Other miscellaneous expenses

$___________

(Please describe :_____________________________________________)

DO NOT CLAIM ANY MEALS FOR REIMBURSEMENT. The amount of Meals

and Incidental Expenses (M&IE) reimbursed is set at a fixed rate of $71.00 per day while

you are on official government business. You will receive ¾ of the M&IE rate for each

day you are in travel.

PRINT NAME: _________________________________________________________

SIGNATURE: _________________________________________________________

DATE: __________________________

Niddk Advisory Council Travel Expense Form

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