DOC ID #
Date Time Date Time
Cost
Pre-Paid or City
P-Card
Empl Paid
Registration and event fees __________
Note meals included in the registration fee
Transportation to and from destination (airfare, baggage fee,
mileage, taxi fare) __________
Lodging expenses __________
Meals and Incidentals (at per diem rate x number of official
business days less disallowed meals) __________
Per diem rate schedule as set by the Federal Government at:
Miscellaneous (including destination transportation, parking, etc) __________
__________
Fund __________ Dept __________ Div __________ Cost Ctr __________ Object _________ $_________
Fund __________ Dept __________ Div __________ Cost Ctr __________ Object _________ $_________
Fund __________ Dept __________ Div __________ Cost Ctr __________ Object _________ $_________
Fund __________ Dept __________ Div __________ Cost Ctr __________ Object _________ $_________
Date:
Dept Travel Approver Name:
Approver Signature:
Date:
Traveler Signature:
_________________________________________________________________________________________________________________________
Estimated Departure
Estimated Return
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
TRAVEL ADVANCE SECTION
An advance for out-of-pocket expenses may be requested five business days prior to travel date. The minimum advance given will be $100.00. Any unused
portion must be returned within 30 calendar days of returning from a trip.
Advance Requested: $ ____________________ Date/Time Needed: ___________________ Check # ___________________
______________________________________________________________________________
_________________________________________________________________________________________________________________________
INFORMATION SECTION
ESTIMATED COST SECTION
PAYMENT REQUEST SECTION
Please list payments to be made by the city, either direct to a vendor or reimbursed to the employee, prior to travel date. Attach
any necessary documentation and provide the following information: Date check is needed, amount, name payable to, complete
mailing address, and description of cost.
CITY OF DULUTH
TRAVEL ADVANCE FORM
_______________________________________________________________________________________________________
Employee Name
Department/Division
Destination:
https://www.gsa.gov/travel/plan-book/per-diem-rates
_____________________________________________
$ 0.00
Travel Advance Form Instructions
This form must be sent to the Finance Department prior to travel if:
1. Direct payments or reimbursements are needed prior to the trip
2. A travel advance is requested
It is the traveler’s responsibility to complete this form in a timely manner, especially if pre‐payments are
needed. If the form is not received by the Finance Department in enough time to issue a direct payment
through the normal vendor payment process, the traveler will be responsible for any payments and may
then request reimbursement from the city either prior to the trip or upon returning.
The DOCUMENT ID# is the travel number assigned by the department or Finance Department; it
consists of the three or four‐digit department/division number, the letter “T”, the two‐digit year,
and a threedigit sequence number.
The INFORMATION SECTION should include all required data.
The ESTIMATED COST SECTION should include all estimated costs of the trip, as well as the accounting
distribution of the budgeted funding source.
The TRAVEL ADVANCE SECTION is to be used if the traveler wants an advance for outofpocket expenses.
The minimum advance is $100.00, and will be given within five business days of departure date. Any unused
portion of the advance must be returned with 30 calendar days of returning from a trip. Advances will not be
given for prepayments of registration fees, airfare, room deposit, etc.
The PAYMENT REQUEST SECTION is to be used if the traveler wants the city to make any direct vendor
payments or employee reimbursements prior to the trip for airfare, registration fees, or room deposits. The
traveler should attach any necessary documentation and/or enclosures, and provide the following
information:
1. Date the check is needed (keeping in mind the city’s payment cycle, and allowing mailing time, if
needed)
2. Name and address of payee (vendor for prepayments, employee for reimbursements)
3. Amount and description of cost (identify and attach enclosures)
Please make a copy of this form for your files. The original must be on file in the Finance Department