TA Form 52312
Travel Authorization - Employee
Date: __________________ Division/Department: ______________________________
Full Traveler Name: ______________________________________________
(As appears on passport or Drivers License)
Empl#(ADP) or Student #(917):__________________________ Phone:________________________
Travel Description:
Destination
Depart Date Return Date City State Country
Travel Purpose: _________________________________________________________________
_________________________________________________________________
Transportation Preferences
Preferred Carrier Seating
(Aisle/Window) Preferred Departure Time Preferred Return Time
Estimated Cost
Lodging $ ___________
Airfare or other
Common Carrier $ ___________
(Not To Exceed)
Meals $ ___________ Personal Auto:
Miles ________
Registration $ ___________ Rate ________
Cost $ ___________
Misc/Other $ ___________
Rental Car $ ___________
Total $ ________________
Account Distribution:
Fund Dept Id Program Class
Project*
Amount
Ln 1
Ln 2
Ln 3
* Requires approval of Sponsored Operations
Approving Official
________________________ __________________________ _____________
Print Name Signature Date
Research & Sponsored Projects __________________________ ______________
(If Required) Signature Date
Faculty In State
Staff Out of State
Mileage (Only) Foreign
