Fillable Employee's MUW ID No (950) Name of Attendee (Mississippi University for Women)

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Employee's MUW ID No (950) Name of Attendee (Mississippi University for Women)

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Employee's MUW ID No (950) Name of Attendee
Address
Department
Estimated cost $
Budget Manager Date
Supervising Cabinet Member
Date
Conference Registration Fee Account Amount
Other Fees associated w/ Conference
Date
Budget Manager
Date
All signatures provided
Fund Account Amount
All sections completed and legible
Provided conference documentation
Proof-of-attendance provided
Accounting information provided
Approved reimbursement to traveler
Travel Auditor
Date
PENALTY FOR FRAUDLENT CLAIM (Section 25-1-81 and 25-1-91, MS code Ann. (1972)). Fine of not more than $250; civilly liable for amount received illegally; removed from
office or position held
Org
AMOUNT
FUND
ORGANIZATION
UNIVERSITY ACCOUNTING OFFICE USE ONLY
SECTION 3 APPROVAL FOR PAYMENT
I CERTIFY THAT THE ABOVE AMOUNT CLAIMED BY ME FOR COVID VIRTUAL CONFERENCE EXPENSES, FOR THE PERIOD INDICATED IS TRUE AND JUST IN ALL RESPECTS. THE
PAYMENT FOR ANY PART HAS NOT BEEN RECEIVED.
SECTION 1 CONFERENCE AUTHORIZATION
Date (s) of conference or virtual content ______ / ______ / ______ to ______ / ______ / ______
SECTION 2 REIMBURSEMENT
Mississippi University for Women
Official Online Conference Attendance by MUW Employees
COVID VIRTUAL ATTENDANCE AUTHORIZATION FORM
Purpose of conference attendance (Reference to organization must show full name - NO ACRONYMS OR ABBREVIATIONS)
Organization
Fund
Organization
TO BE COMPLETED BY CONFERENCE ATTENDEE
COMPTROLLER USE ONLY
Signature of Attendee
Net Reimbursement
Amount owed to Attendee
Total Conference Cost
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Employee's MUW ID No (950) Name of Attendee (Mississippi University for Women)

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Completed 1 February 2021

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