Texas State University 1701 Directors Blvd., Suite 530, Austin, TX 78744 Phone (800) 687-8528 * * * * / / Destination: Date & Time You Left Headquarters: @ m. * * / / Date & Time You Returned to Headquarters:* @ m. * * Name: Employer: *Address: * Title: * TX * * ( ) - City: Zip: Phone: * Purpose of Trip: To Attend Committee To Lecture To Monitor Other: * REQUIRED INFORMATION 1. TRANSPORTATION: a. (Actual from point to point. TAXI FARES Paid Receipt Required) Departed From: On: / $ . / Departed From: On: / $ . / TOTAL . $ TAXI: b. AIR FARE: (Attach Original Paid Ticket or Receipt with payment TOTAL $ validation) AIRFARE: . c. PERSONAL CAR MILEAGE: Grant Condition 27(d) stipulates mileage is reimbursable at $0.45 per mile for use of the claimant's vehicle. Mileage between destination points must be calculated using a mapping website (e.g. MapQuest, Google Maps). Must attach copy of point to point documentation. Miles Miles To Total Miles: @ $.45¢ Per Mile TOTAL MILEAGE: $ . d. PARKING (Original Airport: $ . Hotel: $ . TOTAL PARKING: $ . Receipt Required) e. OTHER (Original Paid Fuel: *Car Rental: $ . $ . Receipt Required) Tolls: $ . TOTAL OTHER: $ . TOTAL . Refer to car rental list of non-reimbursable charges *NOTE: $ TRANSPORTATION: 2. LODGING: f. LODGING: Room $ Local Tax . $ . Only: $ . LODGING: 3. MEALS: g. MEALS: Receipts not required. Reimbursement for ACTUAL expense not to exceed $36.00 per Day (excludes Tips & Alcohol). / / / / / / / / / / Dates: Total: $ $ $ $ $ . . . . . TOTAL MEALS: $ . total reimbursement claimed. I, the Claimant, certify (a) that the above is true and accurate, (b) that dual compensation is not involved for travel or subsistence, and (c) that all compensation claimed is related to Training Center functions. Signature: Date:
Texas State University 1701 Directors Blvd., Suite 530, Austin, TX 78744 Phone (800) 687-8528 * Destination: * Date & Time You Left Headquarters: * / / * @ m. * Date & Time You Returned to Headquarters:* / / * @ m. * Name: * Employer: *Address: * Title: * City: TX * Zip: * Phone: ( ) - * Purpose of Trip: To Attend Committee To Lecture To Monitor Other: * REQUIRED INFORMATION 1. TRANSPORTATION: a. TAXI FARES (Actual Paid Receipt Required) from point to point. Departed From: On: / / $ . Departed From: On: / / $ . TOTAL TAXI: $ . b. AIR FARE: (Attach Original Paid Ticket or Receipt with payment validation) TOTAL AIRFARE: $ . c. PERSONAL CAR MILEAGE: Grant Condition 27(d) stipulates mileage is reimbursable at $0.45 per mile for use of the claimant's vehicle. Mileage between destination points must be calculated using a mapping website (e.g. MapQuest, Google Maps). Must attach copy of point to point documentation. Miles Miles Total Miles: @ $.45¢ Per Mile TOTAL MILEAGE: $ . d. PARKING (Original Airport: $ . Hotel: $ . TOTAL PARKING: $ . Receipt Required) e. OTHER (Original Paid *Car Rental: $ . Fuel: $ . Receipt Required) Tolls: $ . TOTAL OTHER: $ . *NOTE: Refer to car rental list of non-reimbursable charges TOTAL TRANSPORTATION: $ . 2. LODGING: f. LODGING: Room $ . Local Tax Only: $ . LODGING: $ . 3. MEALS: g. MEALS: Receipts not required. Reimbursement for ACTUAL expense not to exceed $36.00 per Day (excludes Tips & Alcohol). Dates: / / / / / / / / / / Total: $ . $ . $ . $ . $ . TOTAL MEALS: $ . total reimbursement claimed. I, the Claimant, certify (a) that the above is true and accurate, (b) that dual compensation is not involved for travel or subsistence, and (c) that all compensation claimed is related to Training Center functions. Signature: Date: To