Spreadsheet: 204a450f-badc-4427-8935-95c7e002520b
Sheet: Sheet1

DA-02-041 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | PERSONAL VEHICLE USE STATEMENT - DEDUCT COMMUTING MILEAGE | Unnamed: 9 | Unnamed: 10 | Unnamed: 11
TRAVEL EXPENSE REIMBURSEMENT VOUCHER |  |  |  |  |  |  |  | PERSONAL VEHICLE - COST BENEFICIAL TO THE STATE - PERSONAL MILEAGE RATE
DEPARTMENT, INSTITUTION, OR AGENCY |  |  |  |  |  |  |  | STATE VEHICLE - NOT AVAILABLE OR ACCESSIBLE - PERSONAL MILEAGE RATE
VIRGINIA HIGHLANDS COMMUNITY COLLEGE |  |  |  |  |  |  |  | STATE VEHICLE - AVAILABLE OR NOT REQUESTED - FLEET RATE
PREPARE WITH INK OR TYPEWRITER.  USE ADDITIONAL SHEETS WHEN NECESSARY.
 |  |  |  |  |  |  | I HEREBY CERTIFY THAT EXPENSES LISTED BELOW WERE INCURRED BY ME ON OFFICIAL
 |  |  |  |  |  |  | BUSINESS OF THE COMMONWEALTH OF VIRGINIA AND INCLUDE ONLY SUCH EXPENSES
 |  |  |  |  |  |  | AS WERE NECESSARY IN THE CONDUCT OF THIS BUSINESS.
 |  |  |  |  |  |  | I CERTIFY THAT COMMUTING MILES HAVE BEEN DEDUCTED.
 |  |  |  |  |  |  | STATE EMPLOYEE? |  | Yes / No
AIS Account #: |  |  |  |  |  |  | SIGNATURE OF TRAVELER |  |  | DATE
Name:
Address: |  |  |  |  |  |  | TITLE
 |  |  |  |  |  |  |  | Interview Candidate
City: |  |  |  |  |  |  | I HEREBY CERTIFY THAT THE TRAVEL UNDERTAKEN IN THIS REIMBURSEMENT VOUCHER
State: |  | Zip: |  |  |  |  | HAS BEEN REVIEWED AND APPROVED AS NECESSARY FOR THE CONDUCT OF BUSINESS
Vendor ID: |  |  | Suffix: |  |  |  | FOR THE COMMONWEALTH.
 |  |  |  |  |  |  | TRAVELER'S SUPERVISOR |  |  |  | DATE
 | 2.LOCATION AT WHICH EXPENSE WAS INCURRED. POINTS |  |  | 3.  [NAME] |  | 5. AUTO |  |  | 7.  LODGING | 8.  OTHER
1.   DATE | BETWEEN WHICH TRAVEL WAS NECESSARY. METHOD OF |  |  | TRAVELED | 4.  MILEAGE | EXPENSE | 6.  MEALS |  | (SHOW PULLMAN | (ITEMIZE IN | AMOUNT
 | TRANSPORTATION USED AND MILEAGE RATE ALLOWED. |  |  | Deduct | OR FARES | (ITEMIZE IN |  |  | SEPARATELY) | COLUMN 2)
 |  |  |  | Commuting
 | EACH DAYS EXPENSES MUST BE SHOWN SEPARATELY. |  |  | Mileage |  | COLUMN 2) | NO. | AMOUNT
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
 |  |  |  |  | 0 |  |  |  |  |  | 0
I certify all computations are correct and that all necessary |  |  | TOTALS | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0
and required receipts are attached.  Initial _______________ |  |  |  |  |  |  |  | TOTAL SHEET  2 |  |  | 0
VOUCHER NUMBER |  | DATE (MM/DD/YY) |  |  |  |  |  | TOTAL SHEET 3
PURPOSE OF TRIP |  |  |  |  |  |  |  | GRAND TOTAL |  |  | 0
 | CONFERENCE |  | PRESENTATION |  | EXTRADITIONS |  |  | AMOUNT ADVANCED
 | ATHLETICS |  | INVESTIGATIONS |  | FIELD WORK |  |  | Payment/(Due to Agency) |  |  | 0
 | RECRUITMENT |  | EDUCATION |  | OTHER (EXPLAIN)
 |  |  |  |  | ACCOUNTING DISTRIBUTION
TRANS | AGY | GLA | FUND | FFY | PROGRAM | OBJECT |  | REVENUE | AMOUNT | PROJECT
 |  |  | FUND|DET |  | PROG|SUB|ELE |  |  | SOURCE |  | PROJECT | TK                        PH
 | 296
COST | FIPS | PSD | AGY REFERENCE |  | INVOICE |  |  | DUE DATE | [NAME]
CODE |  |  |  | DATE | NUMBER |  |  | MM/DD/YY | NUMBER  / SUFFIX
 | [NAME] |  | CURRENT | DOCUMENT | SUBSIDIARY |  |  | MULTI
 |  |  | NUMBER | SX | ACCOUNT |  |  | PURPOSE
TRANS | AGY | GLA | FUND | FFY | PROGRAM | OBJECT |  | REVENUE | AMOUNT | PROJECT
 |  |  | FUND|DET |  | PROG|SUB|ELE |  |  | SOURCE |  | PROJECT | TK                        PH
 | 296
COST | FIPS | PSD | AGY REFERENCE |  | INVOICE |  |  | DUE DATE | [NAME]
CODE |  |  |  | DATE | NUMBER |  |  | MM/DD/YY | NUMBER  / SUFFIX
 | [NAME] |  | CURRENT | DOCUMENT | SUBSIDIARY |  |  | MULTI
 |  |  | NUMBER | SX | ACCOUNT |  |  | PURPOSE
 | CHECK IF EXPENDITURE DISTRIBUTION CONTINUATION SHEETS ARE ATTACHED