Fillable PANOLA COLLEGE TRAVEL REIMBURSEMENT VOUCHER (Panola College)

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PANOLA COLLEGE TRAVEL REIMBURSEMENT VOUCHER (Panola College)

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PANOLA COLLEGE
TRAVEL REIMBURSEMENT VOUCHER
NAME OF APPLICANT SS#
ACCOUNT NUMBER
DESTINATION
Date_____________________________
Check#___________________________
For mileage for privately owned automobiles used by me for transportation, and for reimbursement for subsistence (meals , lodging, and other
expenses paid by me in the discharge of official duty for the period:
Period: to:
,as per itemized statement on Page 2.
Amount
1. Subsistence: Meals & Lodging
2. Private Vehicle
3. Public Carrier
4. Other Travel Costs
5. Total Costs
6. Less: Advances Received
7. NET To Be Reimbursed, or (Returned)
Subject to any differences determined by verification, I certify that the "Total Costs" (Line 5) claimed by me for travel for the period indicated is
true and just in all respects, and that payment for any part thereof has not been received, except as specified on Line 6 ( Advances) above.
Approved for payment: Total $ ______________________ Applicant's Signature ______________________________________________
Administrator's Signature ______________________________________________ Date ________________________________
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PANOLA COLLEGE TRAVEL REIMBURSEMENT VOUCHER (Panola College)

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Completed 7 October 2020

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