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					                                                                                               WARTBURG COLLEGE

                                                                                       Mileage Reimbursement Calculation




This form should be used to support mileage reimbursements requested on the Wells Fargo P-Card Out-Of-Pocket expense system. This form should be completed, data
should be entered in the P-Card system, and then this completed, signed sheet should be forwarded to the appropriate person reviewing your P-Card transactions. The green
shaded areas should be completed as applicable. The yellow shaded areas are formulas and should not be changed. The funds will be deposited to the bank account you
provided in the P-Card system once a month.




Name:



                Date                                                                                                                                                               TOTAL

Calculation for Mileage Reimb*            Trip 1                 Trip 2              Trip 3               Trip 4            Trip 5           Trip 6           Trip 7

  Starting Location

  Destination
  Miles Driven                              0                      0                   0                    0                  0               0                0
  Number of Days on Trip                    0                      0                   0                    0                  0               0                0
  Number of Travelers                       0                      0                   0                    0                  0               0                0

Mileage Reimbursement                           $0.00                  $0.00               $0.00                $0.00              $0.00           $0.00            $0.00      $           -




  I hereby certify that this is a true statement of expenses
 incurred related to official business for Wartburg College.



                       SIGNATURE                                                     DATE




                                 Approved for Payment


    DEPARTMENT HEAD OR ADVISOR                                                       DATE




                                                           * Do not enter data - for Calculation purposes only:
Mileage Reimbursement:                             $0.00                  $0.00                $0.00               $0.00             $0.00            $0.00            $0.00
                                                   $0.00                  $0.00                $0.00               $0.00             $0.00            $0.00            $0.00
                                                   $0.00                  $0.00                $0.00               $0.00             $0.00            $0.00            $0.00
                                                   $0.00                  $0.00                $0.00               $0.00             $0.00            $0.00            $0.00
Reimbursement for Trip                             $0.00                  $0.00                $0.00               $0.00             $0.00            $0.00            $0.00




                                                                            Mileage Reimbursement Key:
                                         Mileage                 Number                                   Number             Mileage
                                          Limit                    of                Mileage                Daily            Rate if
                                           per                  Business             Reimb                   Car            less than
                                          Day                   Travelers             Rate               Allowance         Daily Limit
                                                     120            1                          $0.11                 $37             $0.41
                                                     160           2-4                         $0.12                 $46
                                                     180            5                          $0.13                 $50
                                                     260           6-7                         $0.17                 $62

				
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