Louisiana State University
Office of Accounting Services
Accounts Payable & Travel
217 Thomas Boyd Hall
REQUEST FOR AUTHORIZATION TO TRAVEL FOR NON WORKER AS516
This form must be completed and approved prior to making any travel reservations for all Non Workers.
Traveler Title Employer
LSUID Department
Contact Phone E-mail
Departure Date
Return Date
Type
Guest
Interviewee
Contract Vendor
Participant
LSU Undergraduate Student LSU Graduate Student
Driving Worktags:
Program
Project Gift Grant
Purpose of Travel
Destination
(City, State and/or Country is required)
From:
To:
Does travel include personal travel?
Yes
No
If yes, please disclose the personal dates and/or personal travel destination(s). Travel costs
may be limited to the lesser of a lowest logical airfare or prorated amount. (See PM-13)
Section A - Foreign Travel (Applies to all travel outside the 50 United States, District of Columbia, Puerto Rico, US Virgin Islands, American Samoa, & Guam)
Are US Dept of State rates being requested?
Is there a US Dept of State Travel Warning or Alert for this destination?
- If yes, complete additional required forms per FASOP: AS-18 "High Risk Travel to Restricted Regions".
Is this Faculty-led travel which includes students?
- If yes, please answer the following:
Is this part of an LSU course? If yes, Course # _____________________________________
Yes
Yes
No
No
No
No
Yes
Yes
Section B - Estimated Expenses (Refer to PM-13 for rates)
Expense
Study/Workhop Stipend
Airfare
Registration Fees
Mileage
Meals (Per Diem)
Lodging
Qty
-
-
Amount
Expense
Qty
Amount
Vehicle Rental
Days
Misc & Incidental
-
Other
-
Total Travel Estimate
Section C - Other Special Approvals Requested
Travel>30 Days
Extension of Temporary Assignment greater than 30 days (attach itinerary/travel plans).
APPROVALS
Signature
Printed Name
Date
Requested by
Supervisor/Dept Head/Chair
or Dean/Director
Vice President
Provost ¹
Assoc VP, Acct Services
2
Notes: For International Travel , the approved AS516 must be submitted to Risk Management via on line entry at
www.lsu.edu/riskmgt/travel/international-travel-insurance.php for emergency notification and insurance purposes, prior to travel departure.
¹ Required for "High Risk Travel" to a Restricted Region
² Required for "Travel > 30 days"; applies to meals/and or lodging reimbursements
Rev 9/19
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