Travel Form
Traveler Information
Traveler Name: UC id: U.S. Citizen Traveler Comments: Vehicle License Payment Method: UC employee and/or UC Student
Complete the following section if private car was used and mileage is being claimed
City of Residence Liability Insurance
Trip Information
Trip Purpose: Duration of Trip: Trip Destination:
City Country Date Date Time Time
One-Way
Round Trip
When did the traveler leave home or office? When did the traveler return home or office?
Location Expenses *Attach receipts or travel miles
Transportation Expenses
Circle: Gas $ or Mileage
Miscellaneous Expenses
Type: Amount: Remarks:
Airfare $_______ Private Car $_______ Shuttle $ _________ Toll $________ BART $_______ Rail/Train $________ State Car $________ Other $_______ Bus $________ Rental Car $________ Taxi/Cab $________
Car Specially Equipped $_________ Parking $_________ University Car $ ____________ Total Transportation: $________________
Billing Information
Special Circumstances which warranted special approval or exceptional expenses Remarks:
Meals and Incidentals *Attach additional sheets if more than 3 days
DATE BREAKFAST LUNCH DINNER INCIDENTAL TOTAL LODGING Supervisor Approval
Total: $
Admin Use Account
Fund
Org
-
Prog
Project
Flex
or
Speedtype