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ROCKINGHAM COUNTY SCHOOLS
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Reimbursement of Travel Expenses
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 in the Discharge of Official Duty
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For the Month of
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Must be submitted within 30 days
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Payee's Name (First, Middle Initial, Last)Code No.
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Payee's Address (Street)Vendor No.
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(City, State, Zip)This instrument has been preaudited in the manner required by the School Budget and Fiscal Control Act.
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School/LocationApproved for Payment
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This is to certify that the above statement is true, and that all travel reported was for travel made in the discharge of my official
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duties in connection with Rockingham County Schools.
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__________________________________________ _____________________________________________________ ___________
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(Claimant Signature) (Date) (Principal/Supervisor Signature) (Date)
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DayFromTo& BackPurposeMileage
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25
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26
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27
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28
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29
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30
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31
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32
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Total Mileage0.0
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Total Mileage x 0.70$0.00
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