COMPTROLLER'S OFFICE
Travel Expense Report (Out-of-State Long Form)
Name of Traveler: Encumbrance & FOAP:
Traveler Vendor A-Number: School/Div & Dept:
Phone Number (10 digits): Email Address:
Breakfast Lunch Dinner Incidentals Amount
Advance
Registration
Other
(describe):
Traveler'sSignature Date
Supervisor's Printed Name
Date
Supervisor's Signature
Date
TOTALTRAVELEXPENSES
LESSADVANCERECEIVEDAND/OREXPENSESPREPAIDBYUNIVERSITYTHATARECLAIMEDABOVE
PublicTransportation
(Air,Bus,Train,etc.)
Transportation&OtherExpenses
DailyExpense
From To Description
TravelSummary(mustincludepurpose,
location(s),anddaterange)
Date
mm/dd/yyyy
Location‐City&State
Mileage
Mileage
Rate
Mileage
Reimb
Amount
Lodging
Meals&Incidentals(PerDiem)
TotalMeal
Allowance
Claimed
INSTRUCTIONS:
Fillouteachapplicablesection.Handwritten,incomplete,orunsigned/datedformswillbereturned.
COFORM‐REVISED 01/18/19
Vice President's Printed Name (if required)
Date
Other Approver's Printed Name (if required)
Date
Vice President's Signature (if required)
Date
Other Approver's Signature (if required)
Date
***IN‐STATETRAVELINEXCESSOF2WEEKSONLY!|IN‐STATETRAVELINEXCESSOF2WEEKSONLY!|IN‐STATETRAVELINEXCESSOF2WEEKSONLY!***