Request For Travel Advance Form - The University Corporation, San Francisco State

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THE UNIVERSITY CORPORATION, SAN FRANCISCO STATE
P.O. BOX 320160. SAN FRANCISCO, CA 94132-0160
CLEAR FORM
REQUEST FOR TRAVEL ADVANCE
DC#
Date:
MAKE CHECK PAYABLE TO:
ENC#:
FUND #
TRAVELER'S NAME:
(Last, First, MI)
ADDRESS:
PROJECT CONTACT:
CITY:
STATE:
ZIP CODE:
CHARTFIELD:
ACCOUNT
-
FUND
-
DEPT ID
-
PROJECT (Grants/Contracts only)
PROJECT PHONE #:
_ _ _ _ _ _ - _ _ _ _ _ - 9 1 0 0 - _ _ _ _ _ _ _ _
CHECK DISTRIBUTION:
FN110
1 0 7 9 0 0 - _ _ _ _ _ - 9 1 0 0 - D R
Mail to payee's address
FN110
Hold/Call for pickup
1 0 7 9 0 2
1 0 4 9 0 1 - _ _ _ _ _ - 9 1 0 0 - C R
ph #
Purpose of Travel (show relationship to purpose of project):
Destination:
Date of Travel:
Where I May be reached:
Method of travel:
Airline
Private Vehicle
Other
*Certification of minimum liability requirements/condition of automobile: I certify that I have liability insurance in force in at least the following amounts:
$15,000 for personal injury to, or death one person; $30,000 for personal injury to two or more persons in one accident; $5,000 for property damage. I further certify that my
automobile is adequate for the work to be performed, equipped with seat belts and safe mechanical condition.
* Applicant's Signature:
CASH ADVANCE REQUEST
Amount of cash advance requested $
Date advance required:
(allow at least ten (10) days for processing)
I agree to submit a properly approved expense claim form within 30 after completion of trip.
Applicant's Signature:
Approvals:
For all travel: approval of Authorized Signature:
Date:
For travel outside of S.F. Bay Area: approval of Dean or Dept. Chair:
Date:
ACCOUNTING USE ONLY
Acct:
Inv Nbr:
Vendor:
Inv Amt:
Rept Amt:
Inv Date:
Spec Msg:
Dup Inv:
Date Received By UCorp
Approved For Allowability
Date Received by A/P Dept
E/Processing
By:_______________
By:____________________
Date:__________________
Date:_____________
Voucher #______________
REV 04.2014

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