TA No.
UNIVERSITY OF ALASKA
OUT OF STATE TRAVEL AUTHORIZATION
Traveler’s Name :
UAF/Banner ID :
Employee Non Employee Student Volunteer
Mailing Address:
Reason for Trip:
Return Date:
Travel From:
Travel To:
Date Leaving :
Meeting Dates:
Personal Dates:
Birth Date:
Mileage #:
(Business-only comparison required)
Seating Preference:
Dept. Name:
Travel Coord:
ARE YOU A CITIZEN OR PERMANENT RESIDENT? No Yes
Dept. Travel/ProCard/JV/PO Used
Estimated Costs:
Transportation: Mode of Travel Air $
Lodging
Days at $
$ 0.00
Days at $
$ 0.00
$
Meals Outbound
Meals Returning
Ground Transport
Registration/Other
$
TOTAL TRAVEL ESTIMATE $
Lodging:
Standard Rate: $ x 150% = $ 0.00
Lodging greater than 150% of the st andard rate will require
a written business justification
Monthly Lodging Rates:
Domestic Lodging
Alaska Lodging
Travel advances must be cleared when the travel expense report is filed, and if not cleared within 30 days of return the advance may be withheld from the
traveler's pay check.
Travel Advance (If Applicable) Amount Requested: ______________
Travel Approvals:
Supervisor / Dept. Head : ___________________________________________________________
Expenditure Authority:
Encumbrance Maintenance
**Travel Coordinator Use Only**
Fund Orgn. Acct. Amount
TOTAL TRAVEL AMOUNT
0.00
Less Travel Card Amount
< >
Less Pro Card Amount
< >
Less Other Amounts
< >
$ 0.00
Encumbrance Total
$ 0.00
Entered By: __________________________________ Date: Comments:
Days at $
____________________
$
Comments
No
Yes
Meals and Incidental Rates Based on Destination Location
Domestic Travel
Expenditure Authority
Delegated:
Ext:
For:
Gender:
M & IE reimbursement at lower of actual cost or per diem
Traveler must present receipts to receive M & IE reimbursement.
*Birth Date, Gender, Mileage and Seating Required for
Airfare Reservation Purposes Only
Self Authorization :
By checking this box I certify I have UAF Self Travel Authorization for domestic travel
(International travel requires supervisor approval)
Date : ________________
Date : ________________
Planned Method of Reimbursement
Dean/Director (out of state approval only):
Date : ________________
2nd (if applicable)
3rd (if applicable)
