Travel Reimbursement Form 2025.xlsx

	A	B	C	D	E	F	G	H	I	J
1
2	TRAVEL EXPENSE REIMBURSEMENT FORM
3									Revised	3/11/2025
4
5	Pay to:				Date:
6
7	Purpose of
8	Expense:
9
10	Travel expenditures (must attach itemized receipts):
11		Round Trip Travel	Mileage			Meals - incl. Tips
12	Date	To:	Miles @	$0.700	Airfare	Breakfast	Lunch	Dinner	Lodging	Totals
13				-	-	-	-	-	-	-
14			-	-	-		-	-	-	-
15			-	-	-	-	-	-	-	-
16			-	-	-	-	-	-	-	-
17			-	-	-	-	-	-	-	-
18			-	-	-	-	-	-	-	-
19			-	-	-	-	-	-	-	-
20			-	-	-	-	-	-	-
21								Sub-total of travel		$ -
22
23	Other travel expenses:
24	Item				Amount		1/15/2024	Meals
25	Parking:				-		Breakfast	$ 10.00
26	Registration:				-		Lunch	$ 15.00
27	Ground transportation (Taxi, Shuttle, Bus)				-		Dinner	$ 25.00
28	Tips: (Other than Meals)				-
29	Car Rental:				-		Daily Total	$ 50.00
30	Other: (list separately)				-
31	Baggage Fee				-		Total Mileage $			-
32					-		Total Meals $			-
33	Sub-total of other expenses:				$ -		Total Lodging $			-
34							Total Fares $			-
35							Total Airfare $			-
36
37							Total of Expenses:			$ -
38
39
40	EXPENSE PAYMENT SUMMARY
41
42	Account #:								Amount:
43
44	Account #:								Amount:	$ -
45
46	Account #:								Amount:	$ -
47
48
49	Employee Signature:						Reimbursement Total			$ -
50							(must match Total of Expenses above)
51
52	Administrator Signature:
53
54
55	Approved by:
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