Traveler'S Checklist - Travel Expenses Summary
ADVERTISEMENT
1T
E
S
RAVEL
XPENSES
UMMARY
Detailed travel information to be found at:
T
I
:
RAVELER
NFORMATION
Name:
_________________________ Phone #: ___________ UW Box#
_________________
Home Address (city/state): ________________ Official Duty Station(city/state): __________________
UW Employee (on payroll):
Y
N
US
C
Y
N
ES
O
ITIZEN
ES
O
C
P
‐94
D
IF NO ATTACH
OPY OF
ASSPORT AND I
OCUMENTATION
T
I
:
RIP
NFORMATION
Purpose of this trip(include destination City and State, Name of event (no acronyms), date(s:
________________________________________________________________________________________
________________________________________________________________________________________
(please use another sheet if necessary)
Date:
Time:
Departure from official station or home:
______
______
am
pm
Arrival at official station or home:
______
______
am
pm
Did trip include PERSONAL TIME?
Y
No
ES
dates & times of day personal time began and ended:
______
______
am
pm
(please use another sheet if necessary)
E
:
XPENSES
Please check the following travel expenses that apply toward requested travel reimbursement:
Original receipts are required for all items exceeding $50.00. Additionally, lodging, car rental, domestic laundry
receipts, and meals paid for others are required regardless of cost.
Airfare (provide itinerary) Paid with CTA?
Y
No
$___________
ES
State Contract used? :
Y
No
ES
Exception Reason:
cheaper flights
no timely flights
no seats
no contract fare
Lodging (provide itemized hotel bill) $_______________
Claiming exception?
Y
No Reason:
conf hotel
lower cost over all
suite req
ES
special event/disaster
ADA/Health/Safety
Car Rental (include receipt):
$_______________
Misc/Other Expenses:
_________________________________________________
(please list expense type and amounts):
_________________________________________________
Registration:
Paid with Procard?
Y
No
ES
Were any meals or other costs included?
Y
No
(Regardless if registration was paid)
ES
Please describe other costs: ___________________________________________________
Meals Included (provide dates of included meals)
Breakfast
Lunch
Dinner
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
__________________________
P
M
:
RIVATE AUTOMOBILE
ILEAGE
From:
________________
To:
__________________ # of miles:_________________
Attach mileage log for vicinity miles or Mapquest for point to point miles.
C
:_____________________________________________________________________________
OMMENTS
________________________________________________________________________________________
________________________________________________________________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial