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Winters Joint Unified School District
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TRAVEL & CONFERENCE REIMBURSEMENT REQUEST
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Reimburse:Date:
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Charge To Purchase Order(s) #:
Purpose:
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*********** See the Travel & Conference Procedures for the reimbursement process.***********
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I. TRANSPORTATION
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Date:Destination:
No. Miles:
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Date:Destination:
No. Miles:
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Total Miles:
@$0.700
per mile
$
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Airfare/Rail:
$
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Vehicle Rental:
$
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Taxi/Uber/Shuttle:
$
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Parking:$
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Bridge Toll:
$
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Itemized receipts must be attached
$
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II. LODGING (Number in Party:
)$
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Itemized receipt must be attached
$
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III. MEALS
(Number in Party:
) (If paying for multiple conference attendees, please indiate names on receipt)
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DateBreakfastLunchDinner
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$$$$
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$$$$
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$$$$
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$$$$
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$$$$
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Incidentals - $5 per night stayed$Total$
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IV. MISCELLANEOUS (Itemized receipts must be attached)
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$
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$
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$
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$
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Itemized receipts must be attached$
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TOTAL REIMBURSEMENT:
$
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Employee Signature
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