Travel Expense Reimbursement Form

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TRAVEL EXPENSE REIMBURSEMENT FORM
Traveler Name
University ID number
Today's Date
Department
Total Amount Requested
Date(s) of Travel
Location From/To
Please state Business Purpose of travel:
Include: 1. main reason for travel (if research provide short description); 2. conference/meeting title; 3. conference/meeting dates;
6. Attach program for conference
4. venue of conference/meeting; 5. Comments.
Residential Address (to mail reimbursement check):
Travel Expense Itemization:
Required Travel Receipts:
Cost
Airfare Expense
flight itinerary, must show proof of payment
Lodging Expense
itemized lodging receipt, must show proof of payment
Car Rental Expense
itemized receipt
Taxi, Shuttle, Bus Expense
receipts required if combined total is greater than $75
Conference Registration
receipt
Baggage Fees
receipt
Parking
receipt
Auto Mileage (number of miles)
copy of auto liability insurance card
Other
receipt
Meals:
total maximum domestic meal expense is $64 per day
Breakfast
itemized receipts
Lunch
itemized receipts
Dinner
itemized receipts
Other
receipt
Foreign Lodging Per Diem (number of days)
flight itinerary
Foreign Meals Per Diem (number of days)
flight itinerary
Total:
$0.00
Account Or Project To Be Charged:
Receipts Smaller Than A Sheet Of Paper Must Be Taped To A Sheet Of Paper.
Attach All Receipts To Completed Form And Submit To The Departmental Office Coordinator.
Traveler Signature
Date
Revised 5/01/11

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Parent category: Business
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