Air/Rail Ticket: (Attach ticket) ________________________________________________________________________________
Check here for Ticketless/Electronic Travel. See instructions. _____________________________________________________
Auto rental: ________________________________________________________________________________________________
Personal automobile mileage:
Parking: ___________________________________________________________________________________________________
Tolls: _____________________________________________________________________________________________________
Taxi/Limo: _________________________________________________________________________________________________
LODGING: ________________________________________________________________________________________________
MEALS: Date
Breakfast:
__________________________________________________________________________________________
Lunch:
__________________________________________________________________________________________
Dinner:
__________________________________________________________________________________________
TIPS:
__________________________________________________________________________________________
TELEPHONE CALLS: _______________________________________________________________________________________
OTHER (specify): ___________________________________________________________________________________________
__________________________________________________________________________________________________________
Name:
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Account:
Amount:
Account:
Amount:
Account:
Amount:
Account:
Amount:
Status:
No. of days:
Staff Visit
Invoice: Yes No
Approved by:
DESCRIPTION OF EXPENSE
Purpose:
Location:
Dates:
DETAIL OF EXPENSES
Please itemize individual charges making up total. Attach re