Spreadsheet: 02d78487-6918-4c7f-b14d-662a0b7fbda5
Sheet: Sheet1

Unnamed: 0 | STATE OF MONTANA | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | IMPORTANT | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17
 | TRAVEL EXPENSE VOUCHER |  |  |  |  |  |  |  |  |  | [NAME] to instructions before preparing. They are listed on the next tab.
 |  |  |  |  |  |  |  |  |  |  | Do not submit vouchers more than twice monthly.
 | [NAME] |  |  |  |  |  |  |  |  |  | MONTH/YEAR
 | Address |  |  |  |  |  |  |  |  |  | DEPARTMENT
 | Circle one | EMPLOYEE |  |  |  |  |  |  |  |  | (DO NOT INCLUDE ANY PURCHASES MADE WITH THE STATE CREDIT CARD)
 | EMPLID |  |  |  |  | Responsibility Center(s) (RC #) |  |  |  |  | HEADQUARTERS
 | Purpose | Briefly explain nature of trip(s):
 |  | 1 |  | 2 |  | 3 |  |  | 4 | 5 | 5 | 6 | 6 | 7 |  | 8 | 9
 | Day | Departure Time | A  am   P  pm | Arrival  Time | A  am   P  pm | Travel Details |  |  | Mode of Travel | Personal Car  or Aircraft Mileage     HIGH RATE | Personal Car  or Aircraft Mileage LOW RATE | Mileage Allowance Miles x Rate HIGH RATE | Mileage Allowance Miles x Rate LOW RATE | Per Diem Allowed  (Attach Lodging Receipt) |  | Other Expenses   (not paid b y state credit card) | Total Amount
 |  |  |  |  |  |  |  |  |  |  |  |  |  | Lodging (not paid by state credit card) | Meals
 |  |  |  |  |  |  |  |  |  |  |  | .565 | .272
 | 1 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 2 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 3 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 4 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 5 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 6 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 7 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 8 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 9 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 10 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 11 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 12 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 13 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 14 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 15 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 16 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 17 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 18 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 19 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 20 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 21 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 22 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 23 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 24 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 25 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 26 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 27 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 28 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 29 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 30 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | 31 |  |  |  |  |  |  |  |  |  |  | 0 | 0 |  |  |  | 0
 | FOR AGENCY USE ONLY |  |  |  | 10 | Column Totals |  |  |  | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
 |  |  |  |  | 11 | Less Travel Advance Received
 | FORM 231 NO. |  |  |  | 12 | Net Reimbursement Due Me
 | FORM 241 NO. |  |  |  | 13 | Net Payment Due State
 | [NAME]. Expenses
 | I hereby certify that:  this is a valid travel claim to the State in accordance with statutes and administrative procedures and does not include any purchases made with the state credit card.
 |  |  |  |  |  |  |  |  | Employee's Signature |  |  |  |  |  |  |  | Date
 | SUPERVISOR'S APPROVAL
 | (Instructions for filling out travel voucher listed on Next TAB)