Guest Travel Disclaimer printable pdf download

Guest Travel Disclaimer

This form must be signed by Guest Travelers of Rensselaer if their travel is booked by and paid

for by the Institute. If the Guest traveler makes their own travel arrangements and pays for

them out-of-pocket, the form does not need to be completed.

 I agree to reimburse Rensselaer for any airline/rail tickets bearing my name, that were

booked and paid for by Rensselaer, that I did not use for Rensselaer business travel.

Print Travelers Name: ______________________________

Traveler Signature:

_______________________________

Date: __________

Information Regarding Arranged Travel

Date Purchased:

Airline:

Rail:

Amount paid for by the Institute:

(to be completed by departmental person who arranged for the travel)

Print Department Representative:_________________________

Name

Extension

Department Representative Signature:_____________________

Date:__________

Department Authorizing This Travel:_____________________________

This form is to be maintained by the department.

Management\Guest Travel Disclaimer.docx

\\iacshome\users$\hudsok\My Documents\SmART\Travel

Guest Travel Disclaimer