VOUCHER # BROWN UNIVERSITY TRAVEL EXPENSE REPORT
(Refer to the Brown Travel Policy and Instructions before completing)
Traveler's Name:
Department:
Purpose of trip:
Address to send check:
#Days: Destination:
Beginning: Ending:
PART 1: TRANSPORTATION
Date(s) Type From
From: To: City/State/Country
Miles Round Trip (X)
Rate
Amount
TOTAL Transportation Expenses
Subtotal1
PART 2: DAILY LIVING EXPENSES
Date(s) Location Room Breakfast Lunch Dinner Miscell. $ Descrip.
$0.00 $0.00
TOTAL Living Expenses
Subtotal2
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
PART 3: OTHER EXPENSES
Certification: I certify that all expenses reported here are appropriate and necessary to the objective of the travel and Registration that no other reimbursement will be forthcoming: _________________________________ _____/___/____ Signature of traveler Total of Other Expenses _________________________________ ____/___/____ Authorized Approval
Subtotal3
$0.00
PART 4: SETTLEMENT
$0.00 $0.00 $0.00
Total Travel Expenses (1+2+3): Less:Personal/Other Funding: Net Travel Expenses: Less: Advances from Brown: VENDORItems Prepaid by Brown: # S/C 1099
PART 5: ACCOUNT DISTRIBUTION
Account# Subcode
Description Amount
$0.00 $0.00 $0.00
Amount
TRAVEL ADVANCE ACCOUNT TRAVELER: DO NOT COMPLETE SHADED AREAS.
TOTAL (must equal Net Travel Expenses
shown in part4)
TRAVEL or money * ORA a personal checkSECTION order Attach payable to Brown University
Traveler: Brown*:
Attn s u p er vis o r s : B e s u r e ac c o u n t in fo r m atio n , s u b c o d e an d d ec r ip tio n ar e filled in b efo r e s ig n in g tr avel r ep o r t.
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