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 | State of Alaska |  |  |  |  |  |  |  |  | Request for Travel Authorization and Booking |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TA Number
 | TRAVELER INFORMATION
 | NAME OF TRAVELER |  |  |  |  |  |  |  |  |  |  |  |  |  |  | LEGAL NAME ON GOV'T ID (if different)
 | DEPARTMENT |  |  |  |  |  |  |  |  | DIVISION |  |  |  |  |  |  |  |  | TITLE |  |  |  |  |  |  |  |  | EMPL NUM
 | [NAME]
 | FROM |  |  |  |  |  |  |  |  |  |  | DEPARTURE DATE |  |  |  | TO(DESTINATION) |  |  |  |  |  |  |  |  |  |  | RETURN DATE
 | PURPOSE OF TRIP
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | ESTIMATED COST: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PART OF GROUP REQUEST:
 | ACTUALS REQUESTED: |  |  |  |  |  |  |  |  |  |  | MEALS PROVIDED: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | THIRD PARTY PAYER: |  |  |  |  |  |  |  |  |  |  | NAME/COMMENTS: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | FINANCIAL CODING |  |  |  |  |  | 00000000-00000-00000000-00% |  |  |  |  |  |  |  |  |  |  |  | 00000000-00000-00000000-00%
 |  |  |  |  |  |  | 00000000-00000-00000000-00% |  |  |  |  |  |  |  |  |  |  |  | 00000000-00000-00000000-00%
 | PERSONAL TRAVEL
 | REQUEST INCLUDES PERSONAL TRAVEL: |  |  |  |  |  |  |  |  |  |  |  |  |  | NOTE: Changing the dates of travel, e.g. extending over the weekend, is considered to be personal travel.
 |  | This request includes a personal travel extension with NO routing change from the state authorized destination(s) AND NO companion certificate. |  |  |  |  |  |  |  |  |  |  |  |  |  |  | This request is for a state authorized airfare quote only. The traveler is responsible for purchasing the air travel themselves due to personal travel that includes a routing change or the use of a companion certificate.
 | STATE AUTHORIZED TRAVEL (DATES, TIMES, DESTINATION, REQUESTED LEAVE)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | REQUESTED ARRANGEMENTS / [NAME]
 | CHECK ALL THAT APPLY:
 | [NAME] INCLUDES:
 | CONFERENCE NAME/CLASS TITLE |  |  |  |  |  |  |  |  |  |  |  |  |  |  | HOTEL CONFERENCE # or NIGHTLY RATE |  |  |  |  |  |  |  |  |  | SHUTTLE PROVIDED?
 | PRESENTER? |  |  | COMMENTS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | TRAVEL ADVANCE NOTICE
 | Note: Travel advances are paid in accordance with [NAME] (AAM) guidelines as defined in section 60.070. In order to receive a travel advance, you must first have a signed Travel Advance Authorization Form on file with the state.
 | http://doa.alaska.gov/dof/manuals/aam/resource/60t.pdf#070 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | http://doa.alaska.gov/dof/forms/resource/trvl_adv_auth.pdf
 | REQUESTED FLIGHT(S)
 | FROM |  |  |  |  |  |  |  | DEPART |  |  | TIME/FLT NO |  |  |  | TO |  |  |  |  |  |  |  | ARRIVE |  |  | TIME
 | REQUESTED HOTEL(S)
 | Note: Actual lodging expenses that exceed $300 room rate per night, excluding taxes, must be approved in advance by the director of the Division of Finance, as specified in the Alaska Administrative Manual (AAM) section 60.240.
 | CITY |  |  |  |  |  |  |  | HOTEL/LOCATION |  |  |  |  |  |  |  | CHECK-IN |  |  | CHECK-OUT |  |  | COMMENTS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | REQUESTED RENTAL CAR(S)
 | CITY |  |  |  |  |  |  |  |  | PICK-UP |  |  |  | RETURN |  |  |  | RETURN LOCATION (if different) |  |  |  |  |  |  |  |  | AWD/4WD
 | SPECIAL REQUESTS/OTHER INSTRUCTIONS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0