2025 Travel & Expense Reimbursement Claim

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1	2025 TRAVEL AND EXPENSE REIMBURSEMENT CLAIM
2	Review Travel Procedure 7450P & Purchasing Authorization 7320P and read instructions on page 2 of this form.
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4	Name						Employee # (required)
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6	Home Mailing Address		Street		City, State, Zip		Job Title and Location
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8	Home Phone			check here if new address			Work Phone
9				check here if new address
10	Travel Expenses
11	Conference/Meeting Name (copy of registration & agenda required):
12	Destination:
13		Time Departed from home/work on day of departure:					AM	Depart Date:
14		Time arrived at home/work on day of return:					PM	Return Date:
15		See reverse for depart/return time details.
16									Amount
17	Commercial Transportation (attach receipts & conference registration). Seat upgrades & travel insurance are not reimburseable.
18	Hotel or Motel (attach receipts & conference registration). Peer-to-peer lodging - Airbnb, VRBO, etc. - is not reimburseable.
19	Registration (staple original receipts)
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21	Meal Per Diem (FOR OVERNIGHT TRAVEL ONLY)
22	Do not claim per diem if the meals were included at the conference. Receipts are not required when claiming meal per diem. Meals are
23	reimbursed at the rates listed below (includes tax and tip):
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25					Date	Breakfast	Lunch	Dinner	Total
26	Rates	In State*	Out-of-State						$0.00
27	Breakfast	$22	$23						$0.00
28	Lunch	$23	$25						$0.00
29	Dinner	$36	$37						$0.00
30	Flight information, conference registration &								$0.00
31	agenda required for meal per diem.							Total Meal Per Diem	$0.00
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33	*Includes greater Portland, OR area					Miles (from reverse side)	0.00	x $0.70/mile	$0.00
34							# miles	mileage rate	dollar amount
35	Miscellaneous Expenses
36	Purchase of digital resources (i.e., online subscriptions, downloads, streaming, etc.), must have Tech Dept approval (see page 2 for details).
37	Receipts are not required for day parking, transit fares, ferry fares, road tolls, rideshare, taxi and shuttle fares. Pre-approved single purchase
38	of misc. expenses must not exceed $350. All purchases from the same vendor on the same day are considered a single purchase (7320P).
39	Date	Paid To (staple original itemized receipts**)			Purpose (attach meeting agenda if claiming meals)				Amount
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46								TOTAL REIMBURSEMENT REQUESTED:	$0.00
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48	CERTIFICATION
49	I hereby certify, under penalty of perjury, that this is a true and correct claim for necessary expenses incurred by me and that no payment has been
50	received on account thereof. I have also read and understand district travel procedure 7450P.
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52	Claimant's Signature:						Date:
53	APPROVAL
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55	Immediate Supervisor/Administrator/ASB Advisor				Date	Budget Account Code			Amount
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58	Additional Budget/ASB Approval Signature (if applicable)				Date	Budget Account Code			Amount
59	Claim for Use of Private Vehicle
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61	Date	From	To	Miles	*Round Trip?	Purpose (must be completed); Provide address if out-of-district location.
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83			TOTAL	0.00	If completing by hand, transfer the number of miles to "# miles" field on page 1
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85					* If round-trip, list total miles.
86	Expense Claims: Claims for travel and expense reimbursement, accompanied by required, original itemized receipts and bearing required signatures, must
87	be forwarded to the Accounts Payable Department no later than the 15th of the month following the month in which the expense was incurred. Claims
88	submitted after this period may not be honored (7450P). Mileage, expense and travel claims may be combined and submitted in one claim for monthly
89	reimbursement. If the total claim is less than $25, it may be included in the next months' reimbursement. This form is for requesting reimbursement only for
90	the expenses you incurred, not for expenses paid by another individual. Purchase of misc. expenses must not exceed $350. All purchases from the same
91	vendor on the same day are considered a single purchase (7320P).
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93	Hotel or Motel: Reimbursement for overnight lodging is allowed when the conference or travel destination is located more than 50 miles (most direct route)
94	from the closer of either the traveler's official residence or official workplace. See 7450P for exceptions to this procedure. Attach conference agenda.
95	Peer-to-peer lodging (Airbnb, VRBO, etc.) is prohibited and is not reimbursable.
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97	Digital resources including online subscriptions/software: When purchasing digital resources (e.g., subscriptions, licenses, etc.) the use of the resource
98	must be approved by the Technology Department. Go to http://go.nsd.org/digreview for a link to the review form. Questions about the review
99	can be directed to Shelby Reynolds (sreynolds@nsd.org). Purchases will not be reimbursed unless pre-approved by the Technology Department and the
100	resource is registered with a district email and location address. Proof of approval must be attached to this form.