Form 3136-R - Reimbursement Claim For Actual Travel Expenses - Independent School District 709 - 2015

Download a blank fillable Form 3136-R - Reimbursement Claim For Actual Travel Expenses - Independent School District 709 - 2015 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 3136-R - Reimbursement Claim For Actual Travel Expenses - Independent School District 709 - 2015 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Independent School District 709
Date: _____________
Reimbursement Claim for Actual Travel Expenses
See Policy 3136, Regulation 3136R prior to submitting request.
Travel claims must be submitted within 60 calendar days of first day of travel.
Claimant’s Name: ____________________________________________ Site: ___________________________ Employee ID: __________
Home Address: ______________________________________________________ City, State & Zip: _______________________________
Conference/Seminar: ________________________________________ Location of Conference (city, state): __________________________
Dates - From: _________________________ Departure Time: __________
To: _________________________ Return Time: __________
R E I M B U R S E M E N T
R E Q U E S T E D
A S
F O L L O W S :
Did you attach?
KEY BUDGET CODE
 Approved Professional Leave
 Proof of Insurance
______________________________
 Original Receipts
 Agenda or Brochure
Airfare
 1366.00
 1368.00
Amount:
$_____________
(In & Out of State)
(Out of State-Federal ONLY)
Transportation
 1366.01
 1368.01
(In & Out of State)
(Out of State-Federal ONLY)
 Personal Car - Mileage: _____ miles @ ____ ¢
 Rental Car
 Taxi
 Shuttle
Amount:
$_____________
(current rate)
Conference Fee or Tuition
 1366.02
 1368.02
 Prepaid by ISD709
 Not Prepaid
Amount:
$_____________
(In & Out of State)
(Out of State-Federal ONLY)
Lodging and Meals
 1366.02
 1368.02
 Prepaid by ISD709
 Not Prepaid
(In & Out of State)
(Out of State-Federal ONLY)
Lodging from (date): ______________ to ______________ Lodging Total: $______________
(attach receipt)
Dates
Breakfast
Lunch
Supper
Total Per Day
_____________ $_________
$_________
$_________
$__________
0.00
Meal Perdiem:
_____________ $_________
$_________
$_________
$__________
0.00
Max $38/day:
Breakfast - $7
_____________ $_________
$_________
$_________
$__________
0.00
Lunch - $10
Dinner - $21
_____________ $_________
$_________
$_________
$__________
0.00
_____________ $_________
$_________
$_________
$__________
0.00
Meal Totals: $_________
$_________
$_________
$__________
Lodging & Meals Amount:
$_____________
0.00
0.00
0.00
0.00
0.00
Other Expenses
Specify: ________________________________________________  __________
 __________
Amount:
$_____________
Totals
SubTotal of Reimbursement:
$_____________
0.00
Less Prepaid Total:
$_____________
Grand Total of Reimbursement:
$_____________
0.00
A U T H O R I Z A T I O N S
InSTRuCTIOnS: If actual expenses fall within 10% of the pre-approved estimated costs, no additional approval is required. The form should be sent
to Accounts Payable for processing. If actual expenses exceed the pre-approved estimated costs by more than 10%, the claimant must obtain additional
approval from the Program Manager / Supervisor before submitting to Accounts Payable.
_____________________________________
_____________
_____________________________________
_____________
Claimant
Date
Program Manager / Supervisor (If over 10%)
Date
Form 3136-R
(Rev. 7/15) w Item # 35-05-003550
WHITE: Accounts Payable YELLOW: Program Manager / Supervisor PINk: Claimant

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Claim For Employee Travel Expense Form Claim For Employee Travel Expense Form Financial
Form Fa 51-03 - Foreign-for-profit Corporation Application - Kansas Secretary Of State - 2015 Form Fa 51-03 - Foreign-for-profit Corporation Application - Kansas Secretary Of State - 2015 Legal
Form 6230 - Alaska Corporation Application For Quick Refund Of Overpayment Of Estimated Tax - 2015 Form 6230 - Alaska Corporation Application For Quick Refund Of Overpayment Of Estimated Tax - 2015 Financial
Form 3587 - California Payment Voucher For Lp, Llp, And Remic E-filed Returns - 2015 Form 3587 - California Payment Voucher For Lp, Llp, And Remic E-filed Returns - 2015 Financial
Form 1040ez - Income Tax Return For Single And Joint Filers With No Dependents - 2015 Form 1040ez - Income Tax Return For Single And Joint Filers With No Dependents - 2015 Financial
Travel Expense Policy - Alberta Association Of The Deaf Requisition For Preapproved Travel Expenses Travel Expense Policy - Alberta Association Of The Deaf Requisition For Preapproved Travel Expenses Business
Form For An Independent School District Fundraiser Application - Brownsville Form For An Independent School District Fundraiser Application - Brownsville Business
Independence School District: Residency Affidavit Independence School District: Residency Affidavit Legal
Independent Education Common Recommendation Form For Students Applying To Independent Schools Independent Education Common Recommendation Form For Students Applying To Independent Schools Letters
Form Mn Ac03 - Annual Claim For Reimbursement Of Supplementary Benefits Form Mn Ac03 - Annual Claim For Reimbursement Of Supplementary Benefits Legal

Related Categories

Parent category: Business
Download
Go