Fillable State Form 49630 - Travel Advance printable pdf download

State Form 49630 - Travel Advance

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TRAVEL ADVANCE

RESET FORM

State Form 49630 (2-00)

Approved by State Board of Accounts-2000

Name of Employee

Division/Section

Dates of Travel

Mode of Travel

Estimated Expenses:

0.00

Hotel

Bus, train, or airfare

Registration

Total

Purpose of Trip:

______________________________________________________________________________

Approved by: __________________________ Date: _______________________

Travel Advance: Check Date _____________ Check Number ______ Amount $___________

Employee Certification:

I understand that this cash advance is to be used for allowable hotel, transportation, and

registration costs relating to this trip and is not made for meal and other costs covered by per

diem. I also understand that I am to submit a properly completed travel voucher within one

week after the completion of this trip and that I am to return the amount of the cash advance

promptly after receiving the travel reimbursement from the state.

__________________________________

______________

Signature of Employee

Date

Reimbursement of Travel Advance:

Date Received:

__________

Employee's Check Number: ____________

Amount Received: __________

State Form 49630 - Travel Advance

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