TRAVEL VOUCHER
Pay to: Title:
Designated Headquarters:
INDEX
FY ACCOUNT NUMBER AMOUNT
INDEX
FY ACCOUNT NUMBER AMOUNT
INDEX
FY ACCOUNT NUMBER AMOUNT
INDEX FY ACCOUNT NUMBER AMOUNT
INDEX FY ACCOUNT NUMBER AMOUNT
Dates of Travel: Description:
DISTRIBUTION: AMOUNT
Expense itemization for in-state travel:
Fares, Public transportation
Taxi Air Fare Rental Car
Personal car mileage
Meals and / or lodging
Parking
Incidental expenses
(itemize)
Expense itemization for out-of-state travel:
Fares, Public transportation
Taxi Air Fare Rental Car
Personal car mileage
Meals and / or lodging
Parking
Incidental expenses
(Itemize)
TOTAL
I certify that the expense account shown above is true, correct, and unpaid.
Claimant
Date Supervisor Date
sign
here
Travel Coordinator Date
Agency
sign
Title Date
Approval
here
0
0
0.575
0
0
0
0
0.575
0
0
0
IN-STATE MEALS AND LODGING
Leave Arrive
Headquarters Headquarters
Meals Lodging TOTAL
not to exceed not to exceed Meals Lodging Total
Date Hour Min. m Date Hour Min. m. State Rate State Rate
TOTAL MEALS & LODGING TOTAL ACTUAL EXPENSE
OUT-OF-STATE MEALS AND LODGING
Leave Arrive
Headquarters Headquarters
Meals Lodging TOTAL
not to exceed not to exceed Meals Lodging Total
Date Hour Min. m. Date Hour Min. m. State Rate State Rate
TOTAL MEALS & LODGING TOTAL ACTUAL EXPENSE
Separate mileage by TYPE of Travel:
Place an "I" for In-State or
an "O" for Out-of-State
Type In-State Out-of-State
Total
ACTUAL EXPENSE
ACTUAL EXPENSE
INFORMATION REQUIRED BY TEXTRAVEL GUIDE Mileage
DATE AND OTHER PERTINENT INFORMATION Point to Point
*Show point-to-point breakdown, including intra-city mileage claims Total:
N/A
N/A
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0