Fillable Nonstateemployee - nonstateemployee

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Nonstateemployee - nonstateemployee

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Arkansas Tech University
Russellville, Arkansas
Non-State Employee/Official Guests Reimbursement Form
In compliance with Sub-Chapter 9 of the State Travel Regulations on non-state employees
and official guests, this letter is authorization for travel reimbursement as listed on the attached travel
reimbursement form. I certify that these individuals are not being reimbursed from any other
source for their travel expenses. These persons have been requested to perform official duties or
functions for Arkansas Tech University in the areas of employee interviews, university sponsored
programs, field trips, workshops, conferences, and/or student recruitment.
Date Name Purpose Department
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
_____________ __________________ ________________________ _____________________
Certification of Travel By:
_____________ ___________________________________________________
Date Vice President or Dean of School
Travel Reimbursement Approved By:
_____________ ____________________________________________________
Date Budget Director
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Nonstateemployee - nonstateemployee

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Completed 24 February 2020

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