TOWN OF GREENFIELD
TRAVEL/CONFERENCE/MEETING REQUEST AND APPROVAL FORM
Date submitted: _____/_____/_____
The information provided below explains the travel plans that I am requesting for Town of Greenfield related work and to receive reimbursement for
the expenses involved.
Employee Name ________________________________________________________________________________________________________
Department ____________________________________________________________________________________________________________
Title/Position __________________________________________________________________________________________________________
Description of Travel ____________________________________________________________________________________________________
Dates: Beg: _____/_____/_____ End: _____/_____/_____ Location: _____________________________________________________________
ESTIMATED EXPENSES: (Please attach brochure or meeting notice).
Mileage: ____________ miles @ $.38/mile $_________________________
Cost of Transportation by taxi, rental car, train, bus, or air $_________________________
Accommodations, Hotels/Motels $_________________________
Registration Fee $_________________________
Meals $_________________________
TOTAL ESTIMATED EXPENSES $_________________________
COMMENTS: _________________________________________________________________________________________________________
_______________________________________________
Employee’s Signature
The Travel plans above have been evaluated and approved.
Maximum reimbursement allowed: $____________________ Account number:______________________________________________________
_______________________________________________ _______________________________________________
Supervisor Signature Department Head Signature
_______________________________________________
Mayor
TO BE SUBMITTED AFTER RETURNING FROM TRAVEL. NOTE: ORIGINAL RECEIPTS AND/OR ORIGINAL CANCELLED CHECK
MUST BE ATTACHED.
ACTUAL EXPENSES
Mileage: _____________ miles @ $.38/mile $_________________________
Cost of Transportation by taxi, rental car, train, bus, or air $_________________________
Accommodations, Hotels/Motels $_________________________
Registration Fee $_________________________
Meals $_________________________
TOTAL ACTUAL EXPENSES $_________________________
Revised: 6/08