Spreadsheet: 52755263-6757-4722-a37a-75e6441247c3
Sheet: TRAVEL AUTH

REQUEST FOR APPROVAL OF TRAVEL AND/OR TRAVEL AUTHORIZATION
Date Submitted |  |  | REQUESTING AGENCY. THE UNIVERSITY OF NORTH CAROLINA-GENERAL ADMINISTRATION
 |  |  | DEPARTMENT OR DIVISION
TRAVELER'S NAME & TITLE |  |  |  |  |  |  |  |  |  |  |  | ADVANCE REQUESTED |  |  |  |  |  |  | MADE
 |  |  |  |  |  |  |  |  |  |  |  | ACCOUNT NO.
TRAVEL TO: |  |  |  |  |  |  |  |  |  |  |  |  | PERIOD BEGINNING |  |  |  |  | PERIOD ENDING
If travel is to Washington DC, route authorization to |  |  |  |  |  |  |  |  |  |  |  | Lobbying Activity?
VP for Federal Relations (K. Rhinehardt) for review → |  |  |  |  |  |  |  |  |  |  |  | DC Yes: |  |  |  |  |  | No:
FOR THE MISSION ESSENTIAL PURPOSE OF: (DESCRIBE)
IN-STATE (OVERNIGHT) |  |  |  |  |  |  |  | EMPLOYEE |  |  |  |  | ESTIMATED COST |  |  |  |  |  |  | AMOUNT
OUT-OF-STATE |  |  |  |  |  |  |  | NON-EMPLOYEE |  |  |  |  | SUBSISTENCE |  |  |  | DAYS AT $
OUT-OF-STATE (OVERNIGHT) |  |  |  |  |  |  |  |  |  |  |  |  | TRANSPORTATION |  |  |  |  |  |  | 0
TRANSPORTATION: |  |  |  | COMMON CARRIER |  |  |  |  | STATE CAR |  |  |  | MILEAGE |  |  |  | [NAME] AT |  | 0.565
 |  |  |  | RENTAL CAR |  |  |  |  | OTHER |  |  |  | REGISTRATION FEES
[NAME] TO PAY ADVANCE REGISTRATION $ |  |  |  |  |  |  |  |  |  |  |  |  | [NAME] EXPENSES |  |  |  |  |  |  | 0
PAYABLE TO: |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TOTAL ESTIMATED COST
Under the provisions of G.S. 138.7, it is also requested that actual expenses be authorized for reimbursement in excess
of the maximum sums specified in G.S. 138.5, or G.S. 138.6, based upon the anticipated extraordinary costs of hotel,
meals or convention registration charges.  Please provide your daily lodging and associated registration fee cost
information below.
 |  |  |  |  |  |  | Please choose applicable lodging cost justification statement for your travel. (CHECK ONE)
DAILY LODGING RATE (PRIOR TO STATE & LOCAL TAXES) |  |  |  |  |  |  |  | Obtained lodging at daily in-state and out-of-state lodging allowances of $63.90 and $75.60 respectively.
 |  |  |  |  |  |  |  | Attempted to procure State rate from local hotels and none offered the State rate for my travel period.  I plan to stay at the lowest cost hotel to which I obtained price and availability information.
 |  |  |  |  |  |  |  | Contract rate for formal State meeting
 |  |  |  |  |  |  |  | Other: provide description in comments section at the bottom of the form.
REGISTRATION FEE
 | I request approval of travel, as indicated above, while in travel status in service to the State of North Carolina.
[NAME]'s Signature |  |  |  |  |  |  |  | (Date) |  |  |  | Department/Division Head |  |  |  |  |  |  |  | (Date)
 | Request approved, subject to compliance with Budget Manual No. 5.9.
Designated Official's Signature |  |  |  |  |  |  |  | (Date)
Comments:  Further mission essential travel justification as needed:
INSTRUCTIONS: This request must be approved by the head of the agency or his designee prior to commencement of
travel status in order to receive a travel advance or travel reimbursement.  Following completion of travel status, this
completed request must be attached to Form BD403-GA Request for Reimbursement of Travel and Other Expenses; the
completed Form BD403-GA and its supporting attachments must be filed with the Services Office for approval and
payment within 30 days after the travel status terminates.
Form No. GA-2, Rev. [NAME]