Travel Authorization Form printable pdf download

Travel Authorization Form

HGTC Travel auTHorizaTion Form

o In-State

o Out-of-State

Name: ___________________________________________________ Date: ____________________________

Destination: _________________________________________________________________________________

Justification or Event: _________________________________________________________________________

_____________________________________________________________________________________________

From Date: __________________________________ To Date: _______________________________________

Trip Report or Brief to follow?

o YES

o NO

Department Charged: _______________________________ Org #: _________________________________

stimatEd

xpEnsEs

Source of Funds

Registration (receipt required):

________________

__________

Lodging (receipt required):

________________

__________

Meals (reimbursed at per diem rate):

________________

__________

Transportation (receipt required except personal mileage): ________________

__________

Total Estimated Expenses: ________________

Reimbursement is provided in accordance with rules and regulations governing travel by State employees.

A copy of guidelines is available in the Finance Office.

ignaturEs

In-state travel requires all but the President’s signature.

Out-of-State travel requires all signatures.

Requestor: ________________________________________________________

Dean/Supervisor: __________________________________________________

Vice President: _____________________________________________________

President (out-of-state only): ________________________________________

PART 1 Rev. 12-14-12

Travel Authorization Form