Name Official Headquarters Date State of Department Division Authorization to Incur Travel Expenses Departure Date Return Date Total Days Purpose of Trip: Destination: Conference or convention travel: Explanation of benefits accruing to the State of Trip Departure Time Return Time Number Total Estimated Per Diem: Registration Fee: Car Motel Motel Confirm Rate Nights Cost Airline Airline Dep. Flight Time Ret. Flight Time Cost TOTAL ESTIMATED COST FOR TRIP Comments: I hereby certify that travel as shown above is to be incurred in connection with official business of the State Signed: Approved by Supervisor: Date Approved- Agency Head Date
State of Name Official Headquarters Date Authorization to Incur Travel Expenses Department Division Purpose of Trip: Departure Date Return Date Total Days Destination: Conference or convention travel: Explanation of benefits accruing to the State of Departure Time Return Time Trip Number Total Estimated Per Diem: Registration Fee: Car Motel Motel Confirm Rate Nights Cost Airline Airline Dep. Flight Time Ret. Flight Time Cost TOTAL ESTIMATED COST FOR TRIP Comments: I hereby certify that travel as shown above is to be incurred in connection with official business of the State Signed: Approved by Supervisor: Date Approved- Agency Head Date
DFS-AA-13AuthorizationtoIncurTravel-Agencies.docx