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Scappoose School District
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EMPLOYEE PER DIEM REQUEST FORM
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*MUST INCLUDE ALL DOCUMENTATION TO SUPPORT PER DIEM REQUEST*
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Name
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Building:
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Position
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Supervisor:
Dates of travel:
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Charge to:From:To:
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Detailed Travel Expenses Incurred for :
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Dates:Amount
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Per Diem Amounts
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 Breakfast $ -
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 Lunch -
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 Dinner -
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 - - - -
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 -
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Total - - - - - - - -
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Employee Signature/Date
Approving Administrator Signature/Date
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* Supporting documentation includes:
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Conference or training schedule/itinerary
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Hotel registration
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Flight information (if applicable)
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GSA per diem rate and breakdown for the City traveling to/from and the MI&E breakdown
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https://www.gsa.gov/
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