Cerritos Community College District
Conference and Travel Expense Claim
Attach an approved Conference and Travel Request Form when submitting a claim to Fiscal Services.
January 2016
PART I: EMPLOYEE/CONFERENCE INFORMATION
Employee Name: Job Title:
Department: Extension:
Name of Conference:
Location (City and State): Dates:
PART II: CONFERENCE AND TRAVEL EXPENSE CLAIM
Forms must be filed within thirty (30) calendar days after return from travel. Forms submitted to Fiscal Services after 30 calendar days, or
forms that are incomplete and do not include the necessary itemized original receipts, may be denied for reimbursement.
Enter Dates Attended
MEALS
Subtotal
Breakfast
Lunch
Dinner
Subtotal - Meals
OTHER EXPENSES
Subtotal
Registration
Lodging
Parking
Taxi/Shuttle
Airfare
Other (Refer to BP/AP 6900)
Describe other: Subtotal - Other Expenses
MILEAGE
# Miles
Total miles per day
Additional Comments:
Subtotal - Mileage (54.0 cents per mile)
Total Personal Reimbursement Request
ACCOUNTS TO BE CHARGED (REQUIRED)
Account Number
Example: 01.0-00000.0-00000-00000-5210-0000000
Percentage Not to Exceed $
PART III: APPROVAL AND AUTHORIZATION – I certify that all amounts claimed were actual and necessary, that the
expenses were incurred by the employee only, and only allowable expenses are included.
Attendee: Signature: Date:
Immediate Manager: Signature: Date:
Vice President Signature: Date:
Special Approval - President/Superintendent Signature: Date:
