Stevens Institute Of Technology Travel And Business Expense Report Form

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10.15.2014 version
Stevens Institute of Technology
edoc #: ____________________
Travel and Business Expense Report Form
PAYEE'S FULL NAME (FIRST, MIDDLE INITIAL, LAST)
SCHOOL/DEPARTMENT
ACCOUNT NUMBER
TELEPHONE NUMBER
Use this form to report all business expenses for which you are requesting reimbursement. This form is to be used for both employees and non-employees. Please visit this site https:// to insure you are using ths most current version of the TABER.
All expenses must conform to the University's Business and Travel Expense Policy. In addition, expenses funded by a grant or contract must comply with the applicable cost principles and regulations of the sponsor. The various government approved reimbursement rates.
INCLUSIVE DATES OF TRAVEL
BUSINESS PURPOSE OF TRAVEL
DEPARTURE DATE:
RETURN DATE:
TRANSPORTATION/LODGING/COMMUNICATIONS
TELEPHONE/FAX/
DATE
HOTEL
AIR/BUS/RAIL
TOLLS
CAR RENTAL
PARKING
CAR SERVICE/TAXI
INTERNET
MISC.
SUBTOTAL
$ 0.00
1
$ 0.00
2
$ 0.00
3
$ 0.00
4
$ 0.00
5
$ 0.00
6
A
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
SUBTOTAL
MILEAGE
RATE
TOTAL MILEAGE
Notes on Mileage Reimbursement Rates:
DATE
STARTING LOCATION
DESTINATION
MILEAGE
(SEE NOTES ON RATES)
EXPENSE
$ 0.00
The mileage reimbursement rate is dependent on three things:
7
$ 0.00
1. Date of the travel
8
$ 0.00
2. Purpose of the travel
9
$ 0.00
3. Funding source of the reimbursing account
10
B
$ 0.00
*Please visit this link for the most current rates: https://
SUBTOTAL
MEALS DURING TRAVEL AND OTHER BUSINESS EXPENSES (Please refer to the Business and Travel Expense Policy;
OTHER BUSINESS EXPENSES
https:// Sections V, paragraphs C and D address meals and per diem specifically.
ALCOHOLIC
RECEIPT
DATE
BREAKFAST
LUNCH
DINNER
BEVERAGES
PER DIEM
SUBTOTAL
OTHER (DESCRIPTION)
(Y or N)
OTHER ((AMOUNT)
$ 0.00
11
17
$ 0.00
12
18
$ 0.00
13
19
$ 0.00
20
14
$ 0.00
21
15
$ 0.00
22
16
C
D
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
SUBTOTAL (OTHER BUSINESS EXPENSES INCURRED DURING TRAVEL)
$ 0.00
SUBTOTAL
I certify that the expenses hereon are correct in all respects, that the amounts as charged have been actually paid by me for traveling expenses or by Stevens as advanced traveling expenses and that the distances specified have been actually and necessarily traveled by
me on the stated dates.
_________________________________________________
____________________________________________________________
____________________
EMPLOYEE'S NAME (PRINT)
EMPLOYEE'S SIGNATURE
DATE
$ 0.00
TOTAL EXPENSES (A+B+C+D)
LESS PCARD EXPENSES AND ADVANCES
RECEIVED
_________________________________________________
____________________________________________________________
_____________________
SUPERVISOR'S NAME (PRINT)
SUPERVISOR'S SIGNATURE
DATE
NET AMOUNT DUE TO TRAVELER
$ 0.00
_________________________________________________
____________________________________________________________
_____________________
DEPARTMENT HEAD'S NAME (PRINT)
DEPARTMENT HEAD'S SIGNATURE
DATE

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