REPORT PERIOD BEGINNING ENDING
MON DATE TUES DATE WED DATE THURS DATE FRI DATE SAT DATE
EXPLANATION OF ITEMS
LAST NAME FIRST NAME M. I.
HOME ADDRESS NUMBER STREET APT.
CITY STATE ZIP CODE
DEPARTMENT BLDG/ROOM TEL. EXT.
*Explain meetings and related and
miscellaneous below. Indicate day
incurred, persons involved and business
TRAVEL & EXPENSE INVOICE
Trans. (Rail, Taxi, Etc.)
Town or City
DAY AND TYPE OF EXPENSE
Account No. (10 digit) Amount Voucher No.
Employee Print: D
Supervisor Print: Date:
Fiscal Agent Print: Date:
Breakfast (Incl. Tips)
Lunch (Incl. Tips)
Dinner (Incl. Tips)
Meetings + Related *
Deduct-Pre Paid Items (enter
Balance Due Employee
RECONCILIATION OF CASH
Grand Total of Expenses
est for Approval form If travel is of non-scholarly capacity,
and TR-1 not previously submitted (unless traveling to state agency).
1. Original Receipts
The following must be attached:
that the above expenses are correct in all respects
; that the distances as charged have been actually and necessarily traveled by me
on the dates therein specified that the amount as charged ha
s been actually paid by me for traveling expenses; that no part of the account
and TR-1 not previously submitted.
Insurance Co.: Coverage:
. Mapquest printout to verify mileage
5. US G
eneral Svcs Admin (GSA) printout to verify per diem.
6. US General Svcs Admin (GSA) printout to verify lodging if non conference travel.
on the dates therein specified that the amount as charged has been actually paid by me for traveling expenses; that no part of the account
has been paid M.S.U. but the full amount id due. I
TIFY that on the date(s) when the above items of expense were incurred the
vehicle I was using on M.S.U. business was covered b
ity insurance as follows:
Employee acting in a scholarly capacity?