Spreadsheet: 0924d35e-0dda-4c9c-b596-dfdb16692d1c
Sheet: Sheet1

Unnamed: 0 | Brock University | Unnamed: 2 | TRAVEL & EXPENSE REPORT | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16
 | Financial and Administrative Services |  |  |  |  | [   ] | Mail to dept
 | [NAME] Name: |  |  |  |  | [   ] | Mail to payee in dept |  |  |  | Cheque Payable in: | [ |  | ] | CDN $
 | Dept: |  |  |  |  | [   ] | Mail to address shown |  |  |  |  | [ |  | ] | US $
 | Address: |  |  |  |  | [   ] | Will pick up from Finance |  |  |  |  |  |  |  | Note: Only one currency per report.  Attach proof of exchange rate
 | Address: |  |  | Postal Code: |  | call |  | ext |  | CHECK HERE IF OUT-OF-CANADA TRAVEL - NO GST |  | [ |  | ]
 | NOTE: | Report should be submitted to Accounts Payable with original receipts attached in order listed below.
 | Date mm/dd/yy | Full Details of Travel/ |  | # km Traveled | Accommodation  $ | Meals                   $ | Parking               $ | Transportation $ (taxi,bus,shuttle) |  | Miscellaneous |  |  |  |  | Total (GST Incl)
 |  | Description of Expense |  |  |  |  |  |  |  | [NAME] | $ Amt
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 | Total distance traveled (km) |  |  | 0 | For manual entry take Total km x .44 and enter in Total column, this row. |  |  |  |  |  |  |  |  |  | 0
 | Totals |  |  | 0 | 0 | 0 | 0 | 0 | 0 |  | 0 |  |  |  | 0 | 0
 | GST extraction for Finance Use Only |  |  | 0 | 0 | 0 | 0 | 0 |  |  | 0 |  |  |  | 0
 | GST Formula for manual entry
 | ADDITIONAL COMMENTS (Use if space above is insufficient for detail necessary to explain purpose of travel. |  |  |  |  |  |  |  |  | Grand Total (GST Incl) |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  | Less: Advance(s) | Enter cheque # here
 |  |  |  |  |  |  |  |  |  | Net Payment Due to Payee
 | CERTIFICATION: |  |  |  |  |  |  |  |  | Returned to Brock **
 | I hereby certify that the expenses listed on this form relate to university business and have not and will not be reimbursed, in whole or in part, by any other source.
 | [NAME]: |  |  |  |  |  |  |  | ** Attach cheque payable to Brock University or pay cash to cashier in Finance department and attach receipt as proof of payment.
 | I hereby certify that any amounts on this form that are for research purposes are for the purposes for which the grant was awarded
 | and have not and will not be reimbursed, in whole or in part, by any other source. |  |  |  |  |  |  |  | ACCOUNT [NAME] OF EXPENSES CLAIMED
 | [NAME] (if different from payee): |  |  |  |  |  |  |  | Research Code  if applicable 1 | Account # xxx-xxx-xxx | Total (GST Incl) |  |  |  | GST
 | Print Name:
 | Signature: |  |  | Date:
 | PAYEE/RESEARCHER |  |  |  | [NAME]/dd/yy
 | Print Name: |  |  | Title:
 | Signature: |  |  | Date:
 | IMMEDIATE SUPERVISOR |  |  |  | [NAME]/dd/yy
 | Print Name: |  |  | Title: |  |  |  |  | Grand Total (must equal above) |  | 0 |  |  |  | 0
 | Signature: |  |  | Date: |  |  |  |  |  | Less: Advance(s) - Please put OC/UC # in box at left | 0 |  |  |  | CR 111-006-018
 |  |  |  |  | [NAME]/dd/yy |  |  |  | Net Payment Due to Payee |  | 0 |  |  |  | 0
 | 1 For Research Accounts Only (33x-xxx-xxx):
 | E1 = Equipment     M1 = Materials, supplies and other expenditures      M3 = Maintenance   S9 = Salaries - Other     T1 = Travel   OH = Overhead
 | Finance Use Only |  | Verified cash receipt attached for funds returned: |  |  |  | Verified by: |  |  |  | Date:
 | version 01/01/07