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Travel Stmt - Employee

Travel Stmt - Employee A B C D E F G H I J K L M N O 1 VALDOSTA STATE UNIVERSITY - Travel Expense Statement 2 To comply with IRS regulations this statement should be turned in for reimbursement no later than 60 days after the expenses were incurred. FOR ACCOUNTING OFFICE USE ONLY 3 NAME OF
TRAVELER: ADDRESS: VENDOR ID # 4 VSU ID # or Last 4 Digits of SSN #: CITY,
STATE, ZIP VOUCHER # 5 TITLE: PHONE
NUMBER: DATE KEYED 6 DEPARTMENT: DEPARTMENT
CONTACT: BATCH # 7 IS THIS TRIP COVERED UNDER A STANDING AUTHORIZATION FOR TRAVEL? YES NO (ATTACH COPY OF COMPLETED AUTHORIZATION FORM) 8 PURPOSE OF TRIP / NOTES: 9 ACCOUNT/BUDGET NUMBERS TO POST TRAVEL CHARGES TO: FOR ACCOUNTING OFFICE USE ONLY 10 OBJECT EXPENSE
- ACCOUNT CODE FUND DEPARTMENT PROGRAM CLASS GRANT ACCOUNT FUND DEPARTMENT PROGRAM CLASS GRANT AMOUNT 11 12 13 14 15 LICENSE PLATE NUMBER OF CAR: 16 DATE
OF TRAVEL DEPART
TIME ARRIVAL
TIME TRAVEL FROM
On origination please specify Home (HM) or Headquarters (HDQ) TRAVEL TO
On completion please specify Home (HM) or Headquarters (HDQ) ODOMETER
READING
START ODOMETER
READING
END DAILY
MILES COMMUTE / PERSONAL
MILES STATE MILES
-----------
REIMB $$ BREAKFAST LUNCH DINNER FOOD
TOTAL LODGING
(ORIGINAL RECEIPT REQUIRED) 17 - - - 18 - - - 19 - - - 20 - - - 21 - - - 22 - - - 23 - - - 24 - - - 25 (CURRENT ALLOWABLE MILEAGE REIMBURSEMENT IS 48.5 CENTS PER MILE) TOTALS: $ - $ - $ - 26 Date of Expense Air, Taxi/Limousine, Parking
(Attach ORIGINAL Receipt) Amount Date of Expense Registration Fee
(Attach ORIGINAL Receipt) Amount Date of Expense All Other Miscellaneous Expense
(Explain and Attach ORIGINAL Receipt) Amount 27 28 29 30 Total Common Carrier, Taxi/Limousine,Parking $ - Total Registration $ - Total Miscellaneous $ - 31 TOTAL SUBMITTED FOR REIMBURSEMENT: $ - 32 33 SWORN STATEMENT AND APPROVAL 34 I do solemnly swear, under criminal penalty of a felony for false statements subject to punishment by not less than one year nor more than twenty years of penal servitude, that the above statements are true and I have incurred the described expenses and the state use mileage in the discharge of my official duties for the state and have not been reimbursed and have not filed nor will file for reimbursement from any other source for said expenses. In addition, I have exercised due diligence by utilizing cost-saving strategies in expending Valdosta State University funds. 35 36 37 38 39 Traveler's Signature: Date: 40 41 Authorized Approver for Budget Unit
(Required & Must be Different than Traveler) Date:

refer page:-------http://www.officesoon.com/doc/12935-travel-stmt-employee