7430F-Travel Reimbursement Form.xlsx

	A	B	D	E	F	G	H	I	J	K	L	M
1	Jt. Jerome School District No. 261
2	TRAVEL EXPENSE REIMBURSEMENT FORM
3												7430F
4
5	Pay to:								Date:
6
7	Purpose of Expense:
8	For Travel Expenses Conference Agenda Must Be Attached.
9	For Travel Expenses Conference Agenda Must Be Attached.
10			Time of Day		Mileage		Meals - Do Not Include Meals Provided at the Conference
11	Date	Round Trip Travel To:	Depart	Return	Miles @	$0.650	Breakfast-$15	Lunch-$20	Dinner-$30	Airfare	Lodging	Totals
12					-	-	-	-	-	-	-	-
13					-	-	-	-	-	-	-	-
14					-	-	-	-	-	-	-	-
15					-	-	-	-	-	-	-	-
16					-	-	-	-	-	-	-	-
17					-	-	-	-	-	-	-	-
18					-	-	-	-	-	-	-	-
19					-	-	-	-	-	-	-	-
20									Sub-total of travel			$ -
21	Other travel expenses:
22	Item			Amount
23	Parking:			-
24	Registration:			-
25	Ground transportation (Taxi, Shuttle, Bus)			-
26	Tips: (Other than Meals)			-
27	Car Rental:			-
28	Other: (list separately)			-
29				-
30				-
31	Sub-total of other expenses:			$ -					Total of Expenses:			$ -
32
33	EXPENSE PAYMENT SUMMARY
34	Account #:										Amount:	$ -
35
36	Account #:										Amount:	$ -
37
38	Account #:										Amount:	$ -
39
40	Employee Signature:										Reimbursement Total:	$ -
41												(must match Total of Expenses above)
42	Administrator Signature:
43
44	Approved by:										Reconciliation Difference:	$ -
45	Revised on:	7/1/2023
46	Revised on:
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