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Jt. Jerome School District No. 261
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TRAVEL EXPENSE REIMBURSEMENT FORM
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7430F
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Pay to: Date:
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Purpose of Expense:
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For Travel Expenses Conference Agenda Must Be Attached.
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Time of DayMileageMeals - Do Not Include Meals Provided at the Conference
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DateRound Trip Travel To:DepartReturnMiles @$0.65Breakfast-$15Lunch-$20
Dinner-$30
AirfareLodgingTotals
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- - - - - - - -
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- - - - - - - -
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- - - - - - - -
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- - - - - - - -
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Sub-total of travel
$ -
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Other travel expenses:
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ItemAmount
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Parking: -
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Registration: -
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Ground transportation (Taxi, Shuttle, Bus) -
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Tips: (Other than Meals) -
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Car Rental: -
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Other: (list separately) -
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-
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-
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Sub-total of other expenses: $ -
Total of Expenses:
$ -
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EXPENSE PAYMENT SUMMARY
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Account #:Amount: $ -
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Account #:Amount: $ -
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Account #:Amount: $ -
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Employee Signature:
Reimbursement Total:
$ -
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(must match Total of Expenses above)
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Administrator Signature:
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Approved by:
Reconciliation Difference:
$ -
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Revised on:7/1/2023
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Revised on:03/17/2026
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