QuickTime™ and a
TIFF (Uncompressed) decompressor
are needed to see this picture.
TRAVEL REIMBURSEMENT FORM
Name: Dates: June 8–11, 2008
Point of Departure: Destination: Denton
Purpose of Trip: From Disunion to Empire Institute
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Personal Auto Mileage: miles @ 50.5 cents $ $
Car Rental $
Other Transportation: Parking:
Bus, Taxi:
Shuttle: $
Meal Expense (Deduct any alcoholic beverage) $
Total: $
Signature: Date:
Return form by JUNE 27, 2008 to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, Texas 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
QuickTime™ and a
TIFF (LZW) decompressor
are needed to see this picture.
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Gary Bell Dates: October 12–13, 2007
Point of Departure: Destination: Austin
Purpose of Trip: Fall 2007 board meeting
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Leslie Blanton Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Albert Broussard Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Norma Cantú Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
QuickTime™ and a
TIFF (LZW) decompressor
are needed to see this picture.
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Jo Anne Christian Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Jackson Curlin Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Maceo Dailey Jr. Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Virginia Dudley Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Juliet García Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Julius Glickman Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Joseph Krier Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Robert Kruckemeyer Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: William Livingston Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Nancy Cain Marcus Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Adair Margo Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Janie Strauss McGarr Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Thomas Mitchell Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
QuickTime™ and a
TIFF (LZW) decompressor
are needed to see this picture.
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Kit Moncrief Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $ $
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense(deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
QuickTime™ and a
TIFF (LZW) decompressor
are needed to see this picture.
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Bettye Nowlin Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $ $
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense(deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Tessa Martinez Pollack Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Bill Ratliff Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Linda Valdez Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Abraham Verghese Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
QuickTime™ and a
TIFF (LZW) decompressor
are needed to see this picture.
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Mary Volcansek Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $ $
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense(deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: George Wright Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: James Veninga Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: J. Sam Moore Jr. Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 40.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)
REQUEST FOR REIMBURSEMENT FOR TRAVEL EXPENSE
Name: Ellen Temple Dates:
Point of Departure: Destination:
Purpose of Trip:
Expenses incurred during travel:
(Attach all receipts for expenses over $6.00)
Airfare $
Lodging $
Personal Auto Mileage: miles @ 48.5 cents $$
Car Rental $
Other Transportation: Parking:
Taxi:
Bus:
Limo: $
Meal Expense (deduct any alcoholic beverage) $
Other (Itemize)
$
TOTAL: $
Signature: Date:
Return Form to:
HUMANITIES TEXAS
1410 Rio Grande Street
Austin, TX 78701
or Fax to: 512-440-0115
Internal Use Only
Expenses Deducted : $
Travel Funds Advanced (if applicable): $
Total Amount Due to Traveler: $
(Humanities Texas does not reimburse expenses for traveling companions)