Spreadsheet: 768d9932-bbf6-4150-be7c-c6954b6ec34f
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Page ____ of ____ | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12
NAME |  |  |  |  |  |  |  | SOCIAL SECURITY # |  |  |  | Key to Color Coding Scheme
 |  |  |  |  |  |  | S - |  | - 0
CAMPUS ADDRESS (MAILING ADDRESS UNLESS OTHERWISE NOTIFIED) |  |  |  |  |  |  |  |  |  |  |  | Fields which require an entry
DESTINATION, PURPOSE, PERSONS(S) SEEN, EXPLANATION UNUSUAL EXPENSES |  |  |  |  |  |  |  |  |  |  |  | Fields which you may enter in
 |  |  |  |  |  |  |  |  |  |  |  | System Calculated Fields
 |  | M / D / Y | M / D / Y | M / D / Y | M / D / Y | M / D / Y | M / D / Y | M / D / Y | TOTALS
 |  |  |  |  |  | /    / | /    / | /    / |  | <----- ENTER DATES
PERSONAL MILEAGE |  |  |  |  |  |  |  |  | 0
CAR MILEAGE AMT DUE |  |  |  |  |  |  |  |  | 0
BREAKFAST (WITH TIP) |  |  |  |  |  |  |  |  | 0
LUNCH (WITH TIP) |  |  |  |  |  |  |  |  | 0
DINNER (WITH TIP) |  |  |  |  |  |  |  |  | 0
*HOTEL/MOTEL |  |  |  |  |  |  |  |  | 0
AIRPORT BUS/LIMO/TAXI |  |  |  |  |  |  |  |  | 0
*RENTAL CAR |  |  |  |  |  |  |  |  | 0
*AIR, RAIL, BUS FARE |  |  |  |  |  |  |  |  | 0
TOLLS/PARKING FEES |  |  |  |  |  |  |  |  | 0
*OTHER:
 | PHONE |  |  |  |  |  |  |  | 0
 | TIPS |  |  |  |  |  |  |  | 0
 | RENTAL CAR GAS |  |  |  |  |  |  |  | 0
OTHER (Ox Tail) |  |  |  |  |  |  |  |  | 0
OTHER (SPECIFY) |  |  |  |  |  |  |  |  | 0
*Original receipts required for expenses marked by
asterisk above.  Attach all receipts and a copy |  |  |  | USE A SECOND SHEET IF NECESSARY |  |  |  | TOTAL | 0
of travel authorization if an advance was taken.
 |  |  |  | [NAME] OF EXPENSES
 |  | BUDGET NO. (18-23) |  |  | SUB | TRAVEL |  | F/P | ALLOWABLE
TC | VOUCHER NO. | ENTER ONE ACCOUNT PER LINE |  |  | CODE | FORM # | DESCRIPT | (71) | EXPENSE
(10-11) | (12-17) | AS REQUIRED |  |  | (24-27) | (28-33) | (34-51) |  | (62-70)
40 |  |  |  |  |  | ADV #1 |  | F
UNLESS |  |  |  |  |  | ADV #2 | TRAVEL | F
__ __ |  | ACCOUNT NUMBER #3 |  |  | SUBCD #3 | ADV #3 | EXPENSE | F | 0
 |  | ACCOUNT NUMBER #4 |  |  | SUBCD #4 | ADV #4 |  | F | 0
 |  |  |  |  | TOTAL ALLOWABLE EXPENSE |  |  |  | 0
50 |  |  |  |  |  | TRAVEL FORM REF # |  | ENTER | 0
UNLESS |  | 0-11501 |  |  | 1340 | ADV #1 |  | AMOUNT
__ __ |  |  |  |  |  |  |  | ADVANCED
 | LAST DAY OF TRIP | DUE DATE |  | HOLD| ENC | EXCESS OF EXPENSE OVER |  |  | AMOUNT DUE
 | INV DATE (52-55) | (56-61) |  | (79) | (80) | TRAVEL ADVANCE |  |  | EMPLOYEE | 0
 | M  |  M  |  D  |  D | M | M | D | D | Y | Y |  |  | EXCESS OF ADVANCE OVER ACTUAL EXPENSE |  |  | AMOUNT DUE
 |  | /     /     /    /    / |  |  | BRING CASH TO CASHIER'S OFFICE FOR PROCESSING |  |  | UVM | 0
I declare that the foregoing is a true and correct statement of the money necessarily |  |  |  |  | APPROVAL SIGNATURE
paid out of travel expenses in the discharge of my official duties during the period |  |  |  |  | (BUDGET MANAGER OR TRAVELER'S SUPERVISOR IF TRAVELER IS THE BUDGET MANAGER)
from__________________to________________________
 |  |  |  |  | SIGNATURE
SIGNATURE OF TRAVELER |  |  | TITLE |  | NAME (please print) |  |  | TITLE
PHONE NUMBER |  |  | DATE |  | PHONE NUMBER |  |  | DATE
1 COPY EACH TO ACCOUNTING, TRAVELER AND DEPARTMENT.