STATE ZIP
DATE
Amount:
Date
Needed:
(COMPLETE ACTUALS AFTER TRAVEL)
EST. COST Sun.____ Mon.____ Tue.____ Wed.____ Thu.____ Fri.____ Sat.____ TOTAL
MILEAGE #
$ -
-
-
-
-
- - - - - - - - -
LESS Amt Paid by Advance/CalCard:
-
Account #
Account #
SIGNATURE OF EMPLOYEE
(To to be signed after expenses are itemized/authorized for payment.)
San Luis Obispo County Community College District
Conference Request/Travel Reimbursement Form
NAME
BANNER ID#
MAILING ADDRESS
CITY
TITLE OF ACTIVITY
LOCATION
PURPOSE OF TRAVEL
(ATTACH ADDITIONAL PAGES, IF NEEDED)
DATE(S) AWAY FROM SITE
DEPARTMENT
MAXIMUM $ ALLOWED
ITEM
PRE-EVENT APPROVAL
Approvals: I find that the proposed travel meets the requirements of District policy and is consistent with the scheduling of any conference or training session to the attended.
EMPLOYEE SIGNATURE
PHONE# or EXTENSION
Advance Request
DIVISION CHAIR/DIRECTOR DATE
VICE PRESIDENT DATE
DEAN DATE
PRESIDENT DATE
EXPENSE DETAIL
TRANSPORATION EXPENSE: AIRFARE,
Date
SIGNATURE OF ADMINISTRATOR
Date
SIGNATURE OF BUDGET OFFICE
Date
* Total expense should not exceed Maximum $ Allowed.
Payable to:
Address:
INCIDENTALS ($5)
AMOUNT DUE TO EMPLOYEE
TAXI, PARKING, ETC.
I hereby certify under penalty of perjury that:
1. I departed at ______ am/pm on ___/___/___and returned at ______ am/pm on___/___/___.
2. The above is an accurate accounting of my incurred expenses while in travel status.
3. The expenses claimed are not reimbursable to me or to the District from any other source.
4. My personal vehicle used for district business has the minimum insurance requirements required by
law under the State of California and I carry a valid driver's license (if applicable).
I have attached the following receipts/documents to
support my reimbusement:
•Conference brochure or meeting agenda
Itemized lodging bill showing zero balance
Conference registration
Rental car, gasoline or mapped route for mileage
Parking, Taxi, other
(MEAL RECEIPTS NOT REQUIRED, AS OF 7/1/19, unless
required by funding agency)
0.00
0.00