Spreadsheet: 65e7f522-0a1d-49f0-9f29-b6ac94b21329
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | TRAVEL EXPENSE REIMBURSEMENT VOUCHER | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | PERSONAL VEHICLE USE STATEMENT - STATE EMPLOYEES ONLY | Unnamed: 33 | Unnamed: 34 | Unnamed: 35 | Unnamed: 36 | Unnamed: 37 | Unnamed: 38 | Unnamed: 39 | Unnamed: 40 | Unnamed: 41 | Unnamed: 42 | Unnamed: 43 | Unnamed: 44 | Unnamed: 45 | Unnamed: 46 | Unnamed: 47 | Unnamed: 48 | Unnamed: 49 | Unnamed: 50 | Unnamed: 51 | Unnamed: 52 | Unnamed: 53
 |  |  |  |  | DEPARTMENT, INSTITUTION, OR AGENCY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PERSONAL VEHICLE - COST BENEFICIAL TO THE STATE - PERSONAL MILEAGE RATE
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE VEHICLE - NOT AVAILABLE OR ACCESSIBLE - PERSONAL MILEAGE RATE
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 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 BUSINESS.
 |  |  |  |  | Name: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATE EMPLOYEE? |  |  |  |  |  |  |  |  |  |  |  | YES |  |  |  | NO
 |  |  |  |  | Address: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SIGNATURE OF TRAVELER |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DATE
 |  |  |  |  | City: |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TITLE
 |  |  |  |  | State: |  |  |  |  | Zip: |  |  |  |  |  |  | - |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I HEREBY CERTIFY THAT THE TRAVEL UNDERTAKEN IN THIS REIMBURSEMENT VOUCHER HAS BEEN REVIEWED AND APPROVED AS NECESSARY FOR THE CONDUCT OF BUSINESS OF THE COMMONWEALTH.
 |  |  |  |  | Vendor ID: |  |  |  |  |  | - |  |  |  |  |  |  |  |  |  | Suffix:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TRAVELER'S SUPERVISOR                      DATE
1. DATE |  |  |  |  | 2. LOCATION AT WHICH EXPENSE WAS INCURRED. POINTS    BETWEEN WHICH TRAVEL WAS NECESSARY, METHOD OF TRANSPORTATION USED AND MILEAGE RATE ALLOWED. EACH DAYS EXPENSES MUST BE SHOWN SEPARATELY. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 3. [NAME] TRAVELED |  |  | 4. MILEAGE |  |  |  | 5. AUTO EXPENSE (ITEMIZE IN SECOND COLUMN) |  |  |  | 6. PER DIEM                   AMOUNT |  |  |  | 7. LODGING |  |  |  | 8. OTHER (ITEMIZE IN SECOND COLUMN) |  |  |  | AMOUNT
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
I certify all computations are correct and that all necessary and required receipts are attached.                            Initial _________ |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TOTALS |  |  |  |  |  |  | 0 |  |  |  | 0 |  |  |  | 0 |  |  |  | 0 |  |  |  | 0 |  |  |  | 0
 |  |  |  |  | VOUCHER NUMBER |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DATE(MMDDYY) |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TOTAL SHEET 2 |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  | PURPOSE OF TRIP
 |  |  |  |  |  | CONFERENCE |  |  |  |  |  |  |  |  |  |  | PRESENTATION |  |  |  |  |  |  |  |  |  |  | EXTRADITIONS
 |  |  |  |  |  | ATHLETICS |  |  |  |  |  |  |  |  |  |  | INVESTIGATIONS |  |  |  |  |  |  |  |  |  |  | FIELD WORK |  |  |  |  |  |  |  |  | GRAND TOTAL |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  | RECRUITMENT |  |  |  |  |  |  |  |  |  |  | EDUCATION |  |  |  |  |  |  |  |  |  |  | OTHER (EXPLAIN)
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | AMOUNT ADVANCED
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Payment/(Due to Agency) |  |  |  |  |  |  |  |  |  |  |  | 0
TRANS |  |  | AGENCY |  |  | GLA |  |  | FUND |  |  |  | FFY |  |  |  | PROGRAM |  |  |  |  |  |  | OBJECT |  |  |  | REVENUE |  |  |  |  | AMOUNT |  |  |  |  |  |  |  |  |  |  |  |  | PROJECT
 |  |  |  |  |  |  |  |  | FUND |  | DET |  |  |  |  |  | PROG |  |  | SUB |  | ELE |  |  |  |  |  | SOURCE |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PROJECT |  |  |  |  | TK |  | PH
COST |  |  | FIPS |  |  | PSD |  |  | AGENCY REFERENCE |  |  |  |  |  |  |  |  |  |  | INVOICE |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DUE DATE |  |  |  |  |  | [NAME]
CODE |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DATE |  |  |  |  |  | NUMBER |  |  |  |  |  |  |  |  |  |  |  | MM   DD   YY |  |  |  |  |  | NUMBER |  |  |  |  |  |  |  | SX
[NAME] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | CURRENT DOCUMENT |  |  |  |  |  |  |  |  |  | SUBSIDIARY |  |  |  |  |  | MULTI- |  |  |  |  |  | 1099 |  |  |  |  | CHECK IF
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | NUMBER |  |  |  |  |  |  |  | SX |  | ACCOUNT |  |  |  |  |  | PURPOSE |  |  |  |  |  |  |  |  |  |  | CONTINUATION
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | SHEET ATTACHED