Reimbursement Voucher for Westminster College Faculty or Staff Travel

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* 1. Requester's name ( Last Name, First Name, please.)

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* 2. Today's date

Date / Time

Date

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* 3. Requester's Department

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* 4. Destination City

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* 5. Destination State

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* 6. Start date of travel

Date / Time

Date

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* 7. End date of travel

Date / Time

Date

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* 8. Account number to use for charges ( no spaces, no dashes)

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* 9. Airfare expense (Enter as number only: ex. 178.45. Do not use dollar sign.)

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* 10. Personal auto expense - at 0.51 per mile - (Enter as number only: ex. 178.45. Do not use dollar sign.)

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* 11. Lodging expense (Enter as number only: ex. 178.45. Do not use dollar sign.)

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* 12. Meals expense (Enter as number only: ex. 178.45. Do not use dollar sign.)

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* 13. Registration and fees expense (Enter as number only: ex. 178.45. Do not use dollar sign.)

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* 14. Miscellaneous (parking, tolls, etc. expense (Enter as number only: ex. 178.45. Do not use dollar sign.)

If any personal travel included in the above expenses, please indicate amount of personal travel. If any expenses were paid via a Westminster credit card, do not include them on this form, but include a copy of the signed Travel Request and PO to the monthly credit card payment request.

Signature of Traveler: _________________________________ Date:

Approvals:

Signature of Supervisor: _________________________________ Date:

Signature of Vice President:_________________________________ Date:

Total amount approved:_____________________

Charge to account:_________________________

Print this form off to obtain needed approvals.