TRAVEL EXPENSE REIMBURSEMENT REQUEST FORM
(Please provide your home address for reimbursement, we cannot reimburse to your work/business address).
Date(s) of Travel:
Purpose of Trip:
Private Car (Plate No.)
Does Car have Liability Insurance:
Domestic meals reimbursement:
(Based on actual receipts up to a daily maximum of $71/day)
Foreign per diem:
(Telephone, Telegraph, Rental and Meeting Room, etc. are other expenses)
Parking, Tolls, Baggage:
ACCOUNT OR PROJECT # to charge:
PLEASE PAPERCLIP ALL RECEIPTS ALONG WITH REQUEST FORM IN AN ENVELOPE.
Non-citizen, foreign visitors must present travel documents before they leave the U.S. The
business office must make photocopies of documents.
(Declaration of Immigration Status by Non-U.S. Citizens for foreign visitors)
I included the following receipts (check all that apply):