UNIVERSITY OF NEBRASKA AT OMAHA
Purpose: Reimbursement claim form for use by University of Nebraska at Omaha employees claiming
travel or miscellaneous expenses.
Notes: This form includes formulas, including totals for the type of expense, daily summaries and mileage.
If you download this form to your computer, you may need to periodically update it from the SAPPHIRE
downloads. Mileage rates are generally updated on January 1 of the year.
If your department uses the SAP Travel Management module, please enter the trip number.
If your department assigns a tracking/trip number to your travel, please enter the number.
Record the document number on the trip number line if claim is input as a parked
Required receipts include: Lodging,
▪ Commercial Travel (airline, bus, rail, and train)
▪ Car Rental (showing all insurances declined)
▪ Gasoline (rental cars or University vehicles only)
▪ Lodging (must claim single rate or provide explanation, receipt must show zero balance)
▪ Registration Fees
▪ Miscellaneous Travel Expenses ($75.00 or more)
Note: Itemized receipts must be provided for all non-travel related supplies purchased while
traveling (e.g. books, CDs, etc).
▪ Meals (including tip & taxes). Itemized receipts are required if the amount claimed exceeds
the US General Services Administration (GSA) established meal and incidental expense (M&IE)
Note: ACTUAL meal expenses must be claimed. Claims appearing to be submitted as per
diem amounts will be questioned.
A claim for reimbursement of a business/official function meal, including a meal purchased for any individual
other than the claimant, must be accompanied by an original itemized meal receipt, a list of attendees and
a meeting agenda and/or a conference flyer or other documentation to substantiate the business purpose
of the meeting.
Receipts Not Needed (unless $75.00 or more per receipt):
▪ Communication expenses (phone, internet, etc.)
▪ Baggage Handling
▪ Intra-city Bus Fares
▪ Parking fees
▪ Taxi, Shuttle, or Limousine
▪ Toll Fees
Expenses NOT reimbursable:
▪ Alcoholic beverages
▪ Personal entertainment/services
▪ Spouse/Companion expenses
Note: This is not an inclusive list and other expenses may or may not be allowed according to University
policy. Contact Accounting Services if you have questions.
Acceptable Proof of Payment:
▪ Original itemized receipt.
▪ A canceled check may be used in combination with an itemized receipt.
▪ A credit card receipt may be used when it includes a detailed itemization of the purchase.
▪ A faxed copy of a receipt may be used in lieu of a lost original receipt if accompanied by a signed
written explanation for the missing original (e.g. "original lost - use copy as original").
▪ A photocopy of an original receipt may be used if accompanied by a signed written explanation for the
missing original (e.g. "original lost - use copy as original").
▪ For international travel receipts, all claims for reimbursement must be expressed in terms of US currency.
Claimant and appropriate approving authority must sign worksheet.
Process: 1. Employee completes worksheet. Worksheet is given to appropriate approving authority.
2. Worksheet is approved and maybe input as a parked invoice by travelers administrative
3. Worksheet is forwarded to Accounting Services for review of compliance with DAS and
University requirements. Parked invoice is posted by Accounting Services and sent
to DAS for processing.
4. Employee is reimbursed via direct deposit of funds.
UNO Travel/Expense Worksheet Info Sheet Last Update 04/2007
University of Nebraska at Omaha Travel/ Expense Worksheet Trip Number
Traveler Departure City Destination
Personnel # Depart Time
Return Time Cost Ctr/WBS $
Purpose of Travel Cost Ctr/WBS $
Saturday Sunday Monday Tuesday Wednesday Thursday Friday
Date (mm/dd/yy) Total Notes
Taxi, Limo, Bus
I claim reimbursement from the State of Nebraska for the above expenses incurred by me in the line of duty and declare that the above List Items Paid Direct by UNO (i.e. Airfare-Airline/Amt, Registration-Payee/Amt)
statement of them is a true account of such expenses for which payment has not been made heretofore by the State of Nebraska.
Claimant Date Dean/Director Approval Date Accounting Date
University Travel Guidelines
*Expenses must be recorded on a daily basis. *MEALS*
* Actual meal expenses must be claimed. Claims appearing to be submitted as per diem amounts will be questioned.
*Original receipts are required for commercial travel, car rental, gasoline, lodging, registration fees, miscellaneous * Itemized receipts are required if the amount claimed exceeds the US General Services Administration (GSA) established
travel expenses of $75 or more. Itemized receipts must be provided for all non-travel related expense. See meal and incidental expense (M&IE) allowances. Rates can be found at www.gsa.gov.
additional section for meal receipt requirements. * Snacks and beverages outside of the normal three meals a day are not reimbursable.
* Meals in the City of Omaha or within 25 miles are not reimbursable, except for recruiting meals or approved University
*Keep your receipts! If you are not sure if a receipt is required, obtain one. If you lose a required receipt, an business meetings. Business meals must be documented with a receipt, a business agenda and a list of names.
affidavit form must be completed.
Trip Breakfast Lunch Dinner
*Receipts stated in foreign currency must be converted to U.S. Dollars. The conversion rate(s) must be noted on the form. One Day Trip Yes, departure No Yes, departure
prior to 6:30 am prior to 5:00pm or
*Personal Entertainment/Services are not allowable reimbursable expenses. return after 7:00 pm
First & Last Yes, departure Yes, departure Yes, departure
*LODGING* Day of a prior to 6:30 am prior to 11:00 am prior to 5:00pm or
*You may be reimbursed for the daily room rate plus any applicable taxes. If another non-University individual stayed Multi-Day Trip or return after or return after return after 7:00 pm
in the room, only the single room rate is reimbursable. If another University individual(s) stayed in the room, please 10:00 am 2:00 pm
provide the name(s) in the Notes area. Allowable GSA% ** 20% GSA M&IE 30% GSA M&IE 50% GSA M&IE
**These amounts should be used for planning purposes only
*CAR RENTAL* *MILEAGE*
*You are covered under the State of Nebraska's fleet policy while on University business. Therefore, you do not need to *Mileage to the airport for a University business trip is reimbursed from the office if the trip begins during normal
purchase Loss Damage or Collision Insurance for rental vehicles. You will not be reimbursed for this cost if you choose working hours or from your home if the trip starts before or after normal working hours.
to purchase coverage.
Last Update 04/2007