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Travel Expense Report |
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Travel Authorization Number |
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Organization |
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Contract |
Project |
Instr. |
WBS |
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Name
(please print) |
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Total Business
Days Away |
Page |
Of |
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Purpose
of Trip |
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MON |
TUES |
WED |
THURS |
FRI |
SAT |
SUN |
TOTAL |
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Itinerary |
Date |
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Destination (City) |
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Private Auto Mileage (#) |
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Item |
Expenses Prepaid by STScI (receipts
necessary) |
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Charge |
1 |
Air Travel |
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$0.00 |
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2 |
Conference,
Seminar
(need receipt) |
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$0.00 |
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3 |
Hotel
(need receipt) |
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$0.00 |
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4 |
Other (explain) |
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$0.00 |
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5 |
Total
Expenses Paid by
STScI |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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Cash Expenses Paid by Traveler (itemize) |
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Transportation |
6 |
Private Auto Mileage
($) |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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7 |
Tolls |
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$0.00 |
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8 |
Parking |
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$0.00 |
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9 |
Air Travel |
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$0.00 |
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10 |
Train |
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$0.00 |
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11 |
Rental Car |
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$0.00 |
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12 |
Gas |
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$0.00 |
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13 |
Local (taxi, bus, etc.) |
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$0.00 |
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14 |
Other (explain) |
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$0.00 |
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Living |
15 |
Room |
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$0.00 |
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Meals - Breakfast |
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$0.00 |
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16 |
Lunch |
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$0.00 |
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Dinner |
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$0.00 |
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Other |
17 |
Telephone &
Telegraph |
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$0.00 |
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18 |
Other (explain) |
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$0.00 |
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19 |
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$0.00 |
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20 |
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$0.00 |
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21 |
Total Cash Expense |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
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Receipts are
required for all items over $25 (including expenses paid
by STScI) and meals over $25 per day. |
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Cash Expense Summary |
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Foreign Exchange Rate
Used |
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Amount |
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(Expenses
must be converted to U.S. dollars prior to being submitted to Accounts
Payable) |
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Total Cash Expenses This
Page |
$0.00 |
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Total Cash Expenses
Attached Pages |
$0.00 |
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Remarks: |
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Total Cash Expenses |
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$0.00 |
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Less Cash Advanced |
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Deliver To: |
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Balance Due Company |
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Balance Due Employee |
$0.00 |
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For Accounting
Use Only |
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Account Number |
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Amount |
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Traveler's Signature* |
Date |
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Department Head's
Approval |
Date |
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Additional Approval (i.e.
P.I., DDRF) |
Date |
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* |
By signing this report, the traveler is indicating that the
information is correct and certifying that all cost submitted are
allowable. (i.e. does not include
alcohol, travel insurance, unrelated personal expenses) |
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Less
Employee Receipt 0124-000 |
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TOTAL |
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