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Revised: 9/9/24
Tazewell County Public Schools
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Reimbursent Request for Travel / Lodging / Food
506 Jeffersonville Street
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Tazewell, Virginia 24651
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Name:
Vendor:
Month:
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Address:
Account Code(s):
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School:
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Please read Policy GCL-Professional Staff Development before completing this form.
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Policies and regulations shall be adhered to, including attaching receipts to support expenses.
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MILEAGE
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DATESTARTING POINTENDING POINT
MILEAGE
Explanation for Travel
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TOTAL Mileage:0 Total Reimbursement @ $0.67 / mile: 0
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HOTEL / LODGING
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Date(s):
Receipt(s) attached?
YESNO
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Reason for Expenditure:
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 Total
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TOTAL MEALS
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Travel Days @ 75%Non-Travel Days @ 100%
Receipt(s) attached?
YESNO
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Ex: Date / Amount SpentEx: Date/Amount
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 Total
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TOTAL REQUESTED REIMBURSEMENT:
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Approval Signatures:
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Employee:Date:
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Immediate Supervisor/Principal:Date:
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Supervisor/Director:Date:
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Finance Director:Date:
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Superintendent / Designee:Date:
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