Fillable Claim for Absence Travel Reimbursement (Taft College)

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Claim for Absence Travel Reimbursement (Taft College)

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File type: PDF

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Claim for Absence Travel Reimbursement
Version 19.1
Revised 8/21/19
29 Cougar Court
Taft, CA 93268
Type of Travel Requested:
Employee Travel
Field Trip* (Initial Below)
Student Travel
Other: _________________________________
_____*By initialing, I acknowledge each participating
student sign and return a Student or Participant waiver
prior to trip.
Method of Transportation:
Personal Vehicle
Commercial Transportation
District Vehicle
(Please Select Vehicle
Preference)
#25 Athletic Bus
#26 Athletic Bus
#62 15 Passenger Van
#65 15 Passenger Van
#71 Malibu
#68 Minivan/SUV
#72 Impala
Charter
Other: _____________
Date of Request
Employee Name / Department
Contact Telephone Number
Event/Purpose
Destination
Institutional Value
Date and Time of Departure
Date and Time of Return
Classes/Hours to Be Missed
Substitute Needed Yes No
FUNDING SOURCE (FOAPAL)
F
O
A
P
Budget Number
Est. Amount
Actual Amount
Budget Supervisor Signature/Approval
Estimated Costs
Actual Expenses Claimed
Separate PO # Required per Vendor
NOTE: Completed forms need to be submitted
Actual
Audit
Estimated Costs
PO #
Prepay
Request
*
to the Business Office within ten (10) days of
the completion of the travel even if there were
no reimbursable expenses incurred.
Cost
(Office Use Only)
Commercial Transportation*
Commercial Transportation
Lodging + Tax*, #/nights:
Lodging plus tax
Registration*
Registration
Mileage
Miles
Mileage
Miles
Meals
Meals Total (Itemize Below):
Other Expenses (Itemized):
Other Expenses Total (Itemize
Below):
Total Expenses
Less Prepayment/Credit Card
Charges
Total Estimated Expenses:
Balance Due:
Pre-Approval Signatures
Actual Expenses Claimed
Initiator:
Initiator:
Immediate Supervisor:
Immediate Supervisor:
Vice President:
Vice President:
Superintendent/President:
Superintendent/President:
Board of Trustees’ Approval Needed Yes No
NOTE: Certifying Signature confirms the initiator is entitled to the
expenses claimed based on WKCCD Policy/Procedure.
ITEMIZED ACTUAL EXPENSES
Per Diem Meal Data
Itemized Other Expenses
Date
Breakfast
$13.00
Lunch
$15.00
Dinner
$20.00
Audit
(Office Use Only)
Description
Actual
Cost
Audit
(Office Use Only)
0
0
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Claim for Absence Travel Reimbursement (Taft College)

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Completed 25 July 2020

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