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TRAVEL EXPENSE REIMBURSEMENT FORM
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VISITOR
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Visitor's NameTravel DatesFrom:KingstonTo:Ottawa
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Contact Address
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For Canada and USA:
A cheque will be sent to this address if no bank info provided 		Purpose
of trip		Algebra Seminar
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Contact email
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Telephone NumberCurrency of your Bank accountCongress
or
Activity's Name
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Visitor is a student?YESNO
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Fund:GR:GF:Checking
List		I have my host invitation's letterI have the program of the activity
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CC:CC 1713PG:PJ:I have all my invoicesI have my bank info document
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ExpensesCurrencyAmountLocation of purchaseTransaction dateSupplier
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Month:
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MealsDay 1Day 2Day 3Day 4Day 5Day 6Day 7Day 8Day 9Day 10Sub-total
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Date
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BreakfastMax. 24.90 $ -
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LunchMax. 25.20 $ -
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DinnerMax. 61.85 $ -
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Incidentals17.3 $ -
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 Sub-total $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
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Personal MileageDay 1Day 2Day 3Day 4Day 5Day 6Day 7Day 8Day 9Day 10Total (0.605 $ / km)
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Distance (km) $ -
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Addresses From: Passengers who
travelled with you:		 1) 3)
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 To: 2) 4)
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Details or commentsGrand Total $ -
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Signatures
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Helpful links
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I hereby certify that these expenses are correct and have been incurred for University of Ottawa business.
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Policy 21
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Procedure 16-11 (Travel expenses)
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Signature (Visitor)Date
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National Joint Council - International per diems
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National Joint Council - Canadian per diems
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Print name (Approver or Host)
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Bank of Canada - Currency Converter
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Request for payment by wire transfer
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Signature (Approver or Host)Date
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