Travel Expense Report Template Page 3
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3CENTRAL STATE UNIVERSITY
Travel Expense Report
Employee Name:
Organization:
Organization Fund No:
John Q. Traveler
XYZ
1234
Date of Travel:
Destination:
1 January 2003
Las Vegas NV
Purpose of Travel:
Amount Authorized:
Gamble till broke
$7,777.77
TRAVEL REIMBURSEMENT INFORMATION
DATE:
01/03/03 01/04/03
01/01/03
01/02/03
DESCRIPTION
Totals
SUN
MON
TUE
WED
THU
FRI
SAT
Lodging daily rate
$848.00
$212.00
$212.00
$212.00
$212.00
Room tax
$168.00
$42.00
$42.00
$42.00
$42.00
Occupancy tax
$84.00
$21.00
$21.00
$21.00
$21.00
Other: Valet parking
$60.00
$15.00
$15.00
$15.00
$15.00
Total Lodging
$1,160.00
$290.00
$290.00
$290.00
$290.00
POV Miles driven
100.0
50.0
50.0
Total POV (x .36/mile)
$36.00
$18.00
$18.00
Total Airfare
$620.00
$620.00
Ground Transportation Type
Sally's Limos car rental company
Daily Rate
$352.00
$88.00
$88.00
$88.00
$88.00
DW Fees
$92.00
$23.00
$23.00
$23.00
$23.00
LC Fees
$48.00
$12.00
$12.00
$12.00
$12.00
Fuel
$179.00
$63.00
$7.00
$52.00
$57.00
Total Ground Transportation
$671.00
$186.00
$130.00
$175.00
$180.00
$0.00
$75.00
$26.00
$25.00
Total Meals
$160.00
$55.00
$110.00
$48.00
$28.00
$30.00
$240.00
$12.00
$18.00
Meals subtotal per day
$85.00
$425.00
$86.00
$71.00
Adjustments
-$507.00
-$45.00 -$385.00
-$46.00
-$31.00
subtotal after adjustment
$40.00
$40.00
$40.00
$40.00
Telephone
$98.00
$58.00
$0.00
$11.00
$29.00
Parking
$0.00
Toll
$0.00
Conference Registration
$2,000.00
$2,000.00
Other: Conference literature
$4,789.00
$4,789.00
Daily Subtotals:
$574.00 $5,267.00
$0.00
$0.00
$0.00 $3,154.00
$539.00
Total Expenses:
$9,534.00
P011255
P003255
P011299
P018555
P012247
Puchase Orders - Checks Issued prior to travel
Amount Prepaid by CSU:
$5,500.00
$2,000.00 $1,800.00
$600.00
$150.00
$950.00
P015587
P0123669
Puchase Orders - Authorized Reimbursements
Amount authorized:
$2,277.77
$2,100.00
$177.77
Amount Authorized:
$7,777.77
Total Expenses:
$9,534.00
Prepaid by CSU:
$5,500.00
Adjust:
Amount due traveler:
$4,034.00
Expenses exceed amount authorized by
$1,756.23
Signature __________________________________________________________ Date ________________________________
Approval ___________________________________________________________ Date _______________________________
(Organization/Area Manager)
ATTACH ALL RECEIPTS
POV mileage must be reported on POV Mileage Report Form for multiple days and/or mileage reimbursement only.
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