HTML Preview Travel & Expense-8-5-08-1X page number 1.
TR NUMBER
REPORT PERIOD BEGINNING ENDING
SUN DATE
MON DATE TUES DATE WED DATE THURS DATE FRI DATE SAT DATE
EXPLANATION OF ITEMS
1
2
3
4
5
6
LAST NAME FIRST NAME M. I.
HOME ADDRESS NUMBER STREET APT.
CITY STATE ZIP CODE
CWID
DEPARTMENT BLDG/ROOM TEL. EXT.
*Explain meetings and related and
miscellaneous below. Indicate day
incurred, persons involved and business
purpose.
TOTALS
TRAVEL & EXPENSE INVOICE
Mileage Allowance
Tolls an
d Parking
Trans. (Air)
Hotel/Motel (Room Only)
Trans. (Rail, Taxi, Etc.)
Auto Rental
Town or City
To:
From:
Daily Mileage
(PERSONAL CAR)
DAY AND TYPE OF EXPENSE
6
7
8
9
10
11
12
Account No. (10 digit) Amount Voucher No.
Employee Print: D
ate:
Signat
ure:
Supervisor Print: Date:
Signature:
Fiscal Agent Print: Date:
Signature:
Hotel/Motel (Room Only)
Breakfast (Incl. Tips)
Lunch (Incl. Tips)
Dinner (Incl. Tips)
Registration Fee
Meetings + Related *
Deduct-Pre Paid Items (enter
negative
number)
Balance Due Employee
Miscellaneous *
DAILY TO
TALS
RECONCILIATION OF CASH
Grand Total of Expenses
2. Requ
est for Approval form If travel is of non-scholarly capacity,
and TR-1 not previously submitted (unless traveling to state agency).
1. Original Receipts
The following must be attached:
EMPLOYEE CERTIFICATION
I certify
that the above expenses are correct in all respects
; that the distances as charged have been actually and necessarily traveled by me
on the dates therein specified that the amount as charged ha
s been actually paid by me for traveling expenses; that no part of the account
and TR-1 not previously submitted.
Insurance Co.: Coverage:
4
. Mapquest printout to verify mileage
5. US G
eneral Svcs Admin (GSA) printout to verify per diem.
6. US General Svcs Admin (GSA) printout to verify lodging if non conference travel.
on the dates therein specified that the amount as charged has been actually paid by me for traveling expenses; that no part of the account
has been paid M.S.U. but the full amount id due. I
also CER
TIFY that on the date(s) when the above items of expense were incurred the
vehicle I was using on M.S.U. business was covered b
y liabil
ity insurance as follows:
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Employee acting in a scholarly capacity?
Yes
No
STUDENT
CHECK IF APPLIES: