Spreadsheet: 3ac3b7a4-0019-4f0c-94ab-ace75aef3aad
Sheet: Travel Form

 |  |  |  |  | YA2228-C TRAVEL EXPENSE SHEET  For Contractors and Volunteers |  |  |  |  |  |  | Reference Number |  |  |  |  | TRAVEL EXPENSE SHEET - Contractors and Volunteers, Page 2 |  |  |  |  |  |  |  |  |  |  | Traveler:
 |  |  |  |  |  |  |  |  |  |  |  | CT
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Meal & Lodging Expense (Conference/Meeting - Attach copy of registration and agenda)
 |  |  |  |  |  |  |  |  |  |  |  | Contract Number: |  |  |  |  | Date |  | 1st Day Time of Depart | Final Day Time of Return | Meal Per Diem Calculation |  |  |  |  |  |  |  | *Receipt Required |  | Total  I. + II. + III.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Meals and Lodging Location/ Expense Description |  |  | County | Per Diem | % of  Per Diem | Meals Provided | I. | II.* | III.*
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Reimbursable Meal Cost | Lodging & Tax | [NAME]. Expenses
 | Date |  |  |  | Name of Payee: |  |  |  |  | Traveler's Home Address: ( no PO Box please)
 | Please do not inlcude any personal miles incurred while conducting business for OYA. |  |  |  |  |  |  |  |  | Vendor/Tax ID #:
 | Mileage Reimbursement and Reason For Travel
 | DATE |  | Rate | Business Destination and Reason for Travel (i.e. name of meeting, type of training, etc.) |  |  | Training Y/N |  | 1 way  or 2? | Route for Private Car Mileage (From Location to Location) |  | Mileage |  | Subtotal Mileage Cost
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | *Misc. Expenses:  Receipts REQUIRED for personal phone calls, each purchase exceeding $25.00, and all non-travel expenses. |  |  |  |  |  |  |  |  |  | Total:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Subtotal Youth Meals, ([NAME]):
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Travel Awards: |  |  |  |  |  |  |  |  |  | Travel Summary:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | accept travel awards as a result of, or associated with, this state business trip. |  |  |  |  |  |  |  | Mileage (Page 1): |  | Meals:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Completion of this block is mandatory (see drop down box). Travel expense reimbursement claims will not be processed if this block is left blank.  Travel awards include, but may not be limited to, airline frequent [NAME] and hotel or car rental frequent customer awards or miles. |  |  |  |  |  |  |  |  |  |  | Lodging & Tax
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME]. Expenses:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Meals and Lodging, Subtotal: |  | TOTAL
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I certify this claim is true and correct, no part has been previously claimed or will be claimed from any other source, and the transportation method reflected in this claim is the most advantageous method to the state: |  |  |  |  |  |  |  |  | I approve this request and certify funds for payment of this claim are available in the approved budget for the period covered and have been allotted for expenditure and the transportation method reflected in this claim is the most advantageous method to the state:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Payee Signature |  |  |  |  |  |  |  | Date | Authorizing Supervisor Signature |  |  |  |  | Date
 | For Accounting Use Only: |  |  |  |  |  |  |  |  |  | Total: |  |  |  |  |  | Requesting Office Coding Information
 | If claim is for a [NAME] travel reimbursement, approval letter received from program office? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Line # |  | T-Code | Index | PCA | AY | AOBJ | Amount | Youth JJIS # |  | Mark One |  | Document No.
 | If "Yes", date of approval letter? |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Parole | Probation
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1 |  | 222
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 2 |  |  |  |  |  |  |  |  |  |  |  | Audited by:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 3
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 5
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 6 |  |  |  |  |  |  |  |  |  |  |  | Date:
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 7