Check one: TREC Job-Required LSA Other (specify)
Member of sponsoring organization?: Yes No Not Applicable
(Your signature here signifies acceptance of travel deductions from your travel fund.)
Personnel TREC LSA Traveler
Name of hotel (optional)
If you are sharing a room, you MUST obtain a receipt for the amount paid.
Meals are reimbursable only for overnight travel. Refer to Out-of-State M&IE as appropriate for maximum allowable rates. Keep records and submit your meal expenses when requesting reimbursement.
Full days: days X $ (reimb. rate) = (a)
Partial Days (Fill in departure and return days ONLY if they are partial meal days; otherwise, count them as full days above.)
Breakfast: X (reimb. rate) = (b) Lunch: X (reimb. rate) = (c) Dinner: X (reimb. rate) = (d)
Do NOT purchase tickets before travel approval is secured.
Attach itinerary or include itinerary below. If your trip involves changing planes, please include arrival and departure times for each plane taken.
Fill out ONLY ONE of the following sections for state or private car (primary driver only).
Traveler must call motorpool to reserve car (1-6141). You will need to know department & FRS no. (obtain from Business Services). $.22/mile for small sedan$.26/mile for large car $.30/mile for mini-van$.43/mile for van
Date and time of state car pick-up and return (required). Pick up: Date: Time: Return: Date: Time: For state car, list ALL drivers (for insurance purposes):
For state car, list ALL drivers (for insurance purposes):
Private Car:
Are you carpooling? Yes No If yes, with whom?
Yes No
If yes, with whom?
Turn in all original receipts. NO RECEIPT, NO REFUND.
Fill out University Travel Approval Form for all travel requests. Leave the Total Estimated Cost line blank.