Out Of State Travel Request Form - Supreme Court Of Mississippi
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1SUPREME COURT OF MISSISSIPPI
OUT‐OF‐STATE TRAVEL REQUEST
Please submit form at least six (6) weeks prior to trip start date.
TRAVELER INFORMATION
Name: ______________________________________________________ Phone: _________________________
Email: __________________________________________ Position/Title: ________________________________
TRIP INFORMATION
Title of Conference: ____________________________________________________________________________
Destination: ____________________________________ Dates of Travel: ________________________________
ESTIMATED COSTS OF TRAVEL
Registration Fee/Tuition
$__________________
*
Attach a copy of conference agenda or
brochure, including reg/tuition fee cost.
Airline Charge
$___________________
*
Attach a copy of ticket estimate(s).
Taxi Fare/Shuttle Fare/Rental Car**
$___________________
*
Attach a copy of taxi/shuttle/rental car
**Evidence that rental car is cheaper than
estimate. Rental car estimate must be from
use of taxi/shuttle MUST be provided
an approved State Vendor with adj rates.
Mileage
$___________________
*If driving vs flying, attach flight estimate.
Lesser of two will be reimbursed.
Hotel Accommodations (Lodging)
$___________________
*Attach a copy of lodging estimate.
Meals
$___________________
*
, Forms Library (Travel)
lists out‐of‐state meal reimbursement rates.
Other Expenses
$___________________
*
__________________________
Other:
________________________________
Total Estimated Cost of Trip
$___________________
Submitted by: _____________________________________________ Date: _____________________________
AOC OFFICIAL USE ONLY:
Finance Department Authorization: _________________________________________ Date: ________________
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Funded By:
Judicial Travel Budget
Drug Court Fund
Local Drug Court Fund
Grant/3
Party
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Other ________________________________________________________________________
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Travel Request:
Authorized
Authorized but not funded
Denied
By: _________________________________________________ Date: _____________________
COMMENTS: _________________________________________________________________________________
_____________________________________________________________________________________________
Mail form and supporting documents to:
Administrative Office of Courts, Post Office Box 117, Jackson, MS 39205‐0117.
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