Travel Reimbursement Form 2017.xlsx
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2017 TCEA
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REQUEST FOR TRAVEL REIMBURSEMENT
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Authorization for payment must have the approval of the Executive Director.
Area expenses must be approved by an Area Director and forwarded to the Executive Director for payment.
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NAME:DATE(S) OF TRIP:
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ADDRESS:CITY, STATE, ZIP:
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PHONE:EMAIL:
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DESTINATION AND PURPOSE OF TRAVEL:
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Budget Code: # Trained:ESC/Region:
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To be
You must
Or return
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DateTimeeligible for
leave before
after
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DepartAMBreakfast6:00 a.m.6:00 a.m.
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Lunch
12:00 p.m.
12:00 p.m.
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ReturnPMDinner6:00 p.m.6:00 p.m.
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Total Miles:
claimed @$0.535 per mile(1) $ -
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Meals:
Breakfast(s) @ $ 13.00 = $ -
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Lunch(es) @ $ 15.00 = $ -
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Dinner(s) @ $ 26.00 = $ -
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Total Meals: (no receipts required)
(2) $ -
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Lodging (attach original itemized receipts)
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nights @per night=(3) $ -
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Incidental Expenses (attach original itemized receipts):
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Other Expensess (Taxi, Parking, etc.)
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Total Incidental Expenses
(4) $ -
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TOTAL EXPENSES CLAIMED
(5) $ -
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3/6/2016
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Signature
Date
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Executive Director
Date
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Please forward to: TCEA, P.O. Box 18507, Austin, TX 78760.
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TCEA Credit Card Purchases
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NAME:DATE:
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PURPOSE OF PURCHASE:
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DateDescriptionBudget CodeAmount
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Total: $ -
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2017