HomeMy WebLinkAboutN-460 - Travel Authorization - Expense Claims - AllowancesNameDepartmentPurposeDestinationPeriod FromPeriod ToDeparture TimeArrival Time ChecklistY/N or CommentsDetailsTotalAirParkingRental CarLocal TransportationItem not listedMiles DrivenHotelBreakfastLunchDinnerItem not listedInternetTelephoneItem not listedTuitionBooksItem not listedPersonal VehicleDo you get vehicle allowance?NoneDid conference provide hot breakast?Conference agendaTRAVEL EXPENSE REIMBURSEMENT FORMBackupDid the hotel provide hot breakfast?Hotel website that shows breakfast optionsDid conference provide lunch/dinner?Not reservation, but final receiptHotel receipt after check-out?Conference agendaRental car receipt after check-out?Not reservation, but final receiptOtherDid you drive your personal vehicle?Prior approval from authorizing officialMap for mileage calculation?Will you be reimbursed by another agency for this travel?Any reimbursement or payment for conference talk etcCategoryTransportationLodgingMeals Not ProvidedCommunicationsMap from primary work location to destinationSubtotalLess Any Advance or P-Card Travel Charges Total amount owing to employeeAdvance Travel Request
DateManager/Director SignatureDateFinance SignatureI, having herewith presented by the itemized account for expenses listed above amounting to the total above, do hereby certify under penalty of perjury that the foregoing account is just and true as therein stated; that no payment has been received by me on account thereof; that no rebate of any character, kind or description has been made to me by any person or persons furnishing any of said transportation or subsistence; that the expenses charged were actually and necessarilly incurred and paid by me in lawful money.DateEmployee SignatureGL CodesAmount