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ASU Foundation - Office of the Controller - Appalachian State

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ASU Foundation - Office of the Controller - Appalachian State Powered By Docstoc
					INSTRUCTIONS TO CLAIMANT: PLEASE ATTACHE ALL NECESSARY RECEIPTS AND OTHER SUPPORTING D
FORM AND SUBMIT THE ORIGINAL TO THE CONTROLLER'S OFFICE. ALSO, RETAIN ONE COPY FOR YOUR
RECORDS

                                                                         General
The amounts entered in the detail section and continuation pages of this form will automatically calculate summ
Banner Account. This summary is dependent on the values selected in the detail section of the form. If you sho
questions or need assistance please call the Controller's Office at ext 2110. For current subsistence rates please
Resource Manual

                                             Call the Controller's Office x2110 for current subsistence rates


                                                                  Information Fields

Name of Traveler                       Claimant, name of individual requesting reimbursement

Banner ID                              Nine digit Banner ID number

Department                             Department claimant works for

Title/ Position                        Working title or position title

Address                                Accounts Payable address

ATYP/ SEQ                              Controller's Office Use

Business Purpose                       Specific business purpose of the travel relative to the University's needs

                                                                      Fund Fields

Primary Fund the reimbursement is to be charged to.


   Fund       Amount         Fund(2)     Amount       Fund(3)      Amount       Fund(4)   Amount
  1xxxxx          500.00     1xxxxx        200.00    1xxxxx         100.00                         -



                           Additional funds can be added in addition to the primary fund. Enter the fund and the amo
                           in the corresponding spaces. The distribution of the reimbursement is done via journal ent
                           Office.

                                                                    Signature Lines

Claimant                               Individual Requesting Reimbursement REQUIRED
Supervisor                            Claimant's supervisor REQUIRED

Optional                              Some departments require additional approvals for reimbursements

Controller's Office                   Controller's Office use for verification prior to payment

                                                                  Travel Detail

                                                             Date and Destination(s)

Date                                  Enter the date of travel

From, To, and Time                    Enter departure and arrival cities. Enter the times of departure and arrival.

                                                             Reimbursable Expenses

                        Select from the drop down list the type of expense (Private Car, Air, Meals, etc.) and the co
Expense Type
                        State, Out of State, Out of Country)

                        Enter the mileage rate, if applicable. The total amount will be picked up in this calculation.
Rate
                        will not be an additional amount entered.

                        Enter the miles travelled, if applicable. The total amount will be picked up in this calculatio
Miles
                        will not be an additional amount entered.

Description             Provide a brief description of the expense (Breakfast, Lunch, Dinner, Parking, etc.)

Enter Amt               Enter the amount of the expense to be reimbursed, except for entries where the rate and

Amount                  Calculated Field

                                                                 Summary Fields

Total Expenses                          1,000.00             Total expenses automatically summarized based on the
Deduct      Airfare paid by pcard         500.00             Deduction Field: Example Air fare paid by p-card
Deduct      Paid out of pocket            100.00             Deduction Field: Example expense paid out of pocket
Deduct Travel Advance                     200.00             Travel Advance: Enter the Amount of any advance receiv
Amount Due Claimant                       200.00             Auto Calculated Field
Amount Due ASU                                               Auto Calculated Field
Amount Subject to State and Federal
Taxes                                                        Used in situation were the reimbursement is reportable
 TS AND OTHER SUPPORTING DOCUMENTS TO THIS
O, RETAIN ONE COPY FOR YOUR DEPARTMENT'S



  will automatically calculate summary balances by
 ail section of the form. If you should have further
 r current subsistence rates please consult the University



 t subsistence rates




 bursement




 e to the University's needs




                 Fund(5)   Amount     Fund(6)     Amount
                               -                      -



 fund. Enter the fund and the amount you want charged
mbursement is done via journal entry in the Controller's
 als for reimbursements




 )




 imes of departure and arrival.

 s

 te Car, Air, Meals, etc.) and the correct classification (In


 ill be picked up in this calculation. In most cases there


 will be picked up in this calculation. In most cases there


nch, Dinner, Parking, etc.)

 pt for entries where the rate and mileage fields are




 atically summarized based on the travel detail.
mple Air fare paid by p-card
mple expense paid out of pocket
 the Amount of any advance received




     the reimbursement is reportable
                                                                 ASU FOUNDATION
                                             REQUEST FOR REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES
                                           INCURRED IN THE DISCHARGE OF OFFICIAL DUTY-INCLUDING PER DIEM

INSTRUCTIONS TO CLAIMANT: Attach all necessary receipts and other supporting documents to this form and submit the original to the Controller's Office. Retain (1) Copy.

Name of Traveler                                                  Banner ID                       Department                                             Date of Request


Title/ Position                                                   Address, Street, City, State, Zip                                                                        ATYP/ SEQ


Business Purpose of the Travel



     Fund          Amount        Fund(2)      Amount    Fund(3)      Amount          Fund(4)          Amount       Fund(5)     Amount          Fund(6)     Amount
                       -                           -                       -                              -                          -                           -

Expense Type                          In State            Out of State                 Out of Country                        Total Expenses                                       -
Air                              731110            -   731210              -         731310           -                      Deduct
Ground                           731120            -   731220              -         731320           -                      Deduct                                               -
Other Transportation             731130            -   731230              -         731330           -                      Deduct Travel Advance
Lodging                          731140            -   731240              -         731340           -                      Amount Due Claimant
Meals                            731150            -   731250              -         731350           -                      Amount Due ASU
Other Expenses                   731160            -   731260              -         731360           -                      Amount Subject to State and
Registration Fees                731190            -   731290              -         731390           -                      Federal Taxes
                                                   -                       -                          -

Internet Charges                                                                     732100               -
Gasoline Charges                                                                     725100               -

Under penalties of perjury, I certify this is a true and accurate                                 I have examined this reimbursement request and certify that it is just
statement of the city of lodging, expenses, and allowances incurred in                            and reasonable.
the service of the state.


                                      (Claimant)                                                                                    (Supervisor)

I have examined this reimbursement request and certify that it is just                            I have examined this reimbursement request and certify that it is just
and reasonable.                                                                                   and reasonable.


                                      (Optional)                                                                                (Controller's Office)


                      Date and Destination(s)                                                                    Reimbursable Expenses
    Date           From; To; and Time of Departure/ Arrival              Expense Type             Rate   Miles              Description                  Enter Amt         Amount
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                                                                                                                                                                       REV 3/11
                                                       APPALACHIAN STATE UNIVERSITY
                                         REQUEST FOR REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES
                                       INCURRED IN THE DISCHARGE OF OFFICIAL DUTY-INCLUDING PER DIEM

INSTRUCTIONS TO CLAIMANT: Attach all necessary receipts and other supporting documents to this form and submit the original to the Controller's Office. Retain (1) Copy.

                   Date and Destination(s)                                                                  Reimbursable Expenses
   Date         From; To; and Time of Departure/ Arrival                Expense Type         Rate   Miles              Description                 Enter Amt      Amount
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Continuation Page 1
                                                       APPALACHIAN STATE UNIVERSITY
                                         REQUEST FOR REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES
                                       INCURRED IN THE DISCHARGE OF OFFICIAL DUTY-INCLUDING PER DIEM

INSTRUCTIONS TO CLAIMANT: Attach all necessary receipts and other supporting documents to this form and submit the original to the Controller's Office. Retain (1) Copy.

                   Date and Destination(s)                                                                  Reimbursable Expenses
   Date         From; To; and Time of Departure/ Arrival                Expense Type         Rate   Miles              Description                 Enter Amt      Amount
                                                                                                                                                                      -
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Continuation Page 2

				
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