HTML Preview Grant Expense Report page number 1.
Date:
Email:
Phone:
Location:
From To
Depart Arrive
A B C
Amount
D
DATE:
I HEREBY CERTIFY THAT I AM THE PAYER FOR ALL ITEMS OF EXPENSE INCLUDED IN THE ABOVE AMOUNT AND THAT
THE ITEMS WERE NECESSARY IN ATTENDING THE STATED CONFERENCE; AND I DECLARE, UNDER PENALTIES OF
PERJURY THAT THIS CLAIM HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLDGE AND BELIEF IS TRUE,
CORRECT AND VALID CLAIM AND FOR VALUE RECEIVED.
Expense Description / Purpose
GPSC Travel Grants
Total Funding (Must Match Total Expenses):
[Funding 1]
[Funding 2]
Own Pocket
CLAIMANT SIGNATURE:
Transporta
tion
Exchange
Rate
Funding
Student Travel Expense Report (add additional expenses on separate page)
Miscellaneous Expenses
Time of
LodgingDate: Meals
University of Arizona® Graduate and Professional Student Council
GPSC TRAVEL GRANTS TRAVEL EXPENSE REPORT
Traveler & Departmental Information
Travel Information
Last Name:
First Name:
SID:
Graduation Date:
Title of Conference:
Conference Dates:
[Funding 3]
Department:
Totals for all travel expenses:
Total Misc:
Total Expenses (A+B+C+D):
Description / Destination (include type of transportation)
Click to Reset
[If you did not present at a conference, please indicate the type of travel and provide brief details (e.g., fieldwork, lab,
workshop, competition).]
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00