Mileage

							EMPLOYEE EXPENSE REPORT - Mileage & Parking Only
                Name & Location:                                                                                                                                               Employee #

List the District building code and any other facility/cities using dashes in between locations in the "locations from to" field                                                                                                                                                  District
examples: (1) do-avhs-do =$5.71 (2) do-ties-do = actual mileage (error message stating invalid district code, select ok and actual mileage will be put in the mileage chart column, add actual mileage to the actual mileage column)                                              Building
                                                                                                                                                                                                                                                                                  Code
                Date                     Locations from to                                           Mileage Chart                  Actual Mileage                       Parking                                                  Reason                                          DO
                                                                                                                                                                                                                                                                                  DOE
                                                                                                                                                                                                                                                                                  DSC
                                                                                                                                                                                                                                                                                  ALC
                                                                                                                                                                                                                                                                                  AVHS
                                                                                                                                                                                                                                                                                  EHS
                                                                                                                                                                                                                                                                                  EVHS
                                                                                                                                                                                                                                                                                  RHS
                                                                                                                                                                                                                                                                                  SES
                                                                                                                                                                                                                                                                                  BHMS
                                                                                                                                                                                                                                                                                  DHMS
                                                                                                                                                                                                                                                                                  FRMS
                                                                                                                                                                                                                                                                                  RMS
                                                                                                                                                                                                                                                                                  SHMS
                                                                                                                                                                                                                                                                                  VMS
                                                                                                                                                                                                                                                                                  CP
                                                                                                                                                                                                                                                                                  DW
                                                                                                                                                                                                                                                                                  DP
                                                                                                                                                                                                                                                                                  EP
                                                                                                                                                                                                                                                                                  GH
                                                                                                                                                                                                                                                                                  GL
                                                                                                                                                                                                                                                                                  HL
                                                                                                                                                                                                                                                                                  NV
                                                                                                                                                                                                                                                                                  OR
                                                                                                                                                                                                                                                                                  PV
                                                                                                                                                                                                                                                                                  PW
                                                                                                                                                                                                                                                                                  RP
                                                                                                                                                                                                                                                                                  RES
                                                                                                                                                                                                                                                                                  SP
                                                                                                                                                                                                                                                                                  SV
                                                                                                                                                                                                                                                                                  TL
                                                                                                                                                                                                                                                                                  WV
                                                                                                                                                                                                                                                                                  WL
                                                                                                                                                                                                                                                                                  DR
                                                                                                                                                                                                                                                                                  ECLC




                                                           Total Mileage Allowance $                                    -                               -        $                       -
                                                                                                                                                       $0.00
I certify that these expenses are true and correct, pursuant to school district travel regulations and procedures and that no payment or                                                                                                 SUMMARY
reimbursement will be or has been received for these expenses.                                                                                                                                  Mileage: $ per Mileage Chart                                                      $           -
                                                                                                                                                                                                Mileage: Other travel - # of miles x $ 0.51                                       $           -
Employee Signature:                                                   Date:                                                                                                                     Parking                                                                           $           -
Supervisor Approval: I certify that the expenses covered by this claim have been incurred and are a proper obligation of the                                                                    TOTAL                                                                             $       -
school district and payment is hereby recommended.
                                                                 Title:                                                        Date:                                                                                       Account Coding                                             Code Amts

Signature:                                                                                                                                                                                                             FD-ORG-PRG-FIN-OBJ-CRS                                                     -
District Office Approval                                         Title:                                                        Date:
Signature:
     Finance Dept Use Only               Expenses will be reimbursed within five WORKING DAYS from receipt of request in the
                                         Finance Dept. providing all required documents are attached.




                                                                                                                                                                                                                                       63a9d6a0-eb10-45df-9c48-ef71d8622cd0.xls