Travel TERForm by HC12073013433

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									                                                                                                 UWF TRAVEL EXPENSE REPORT (TER)
TAR #:                                                                        TRAVELER'S NAME:                                                                             AGENCY:
AGENCY:                                                                                UWF ID #                                                                    RESIDENCE (CITY):
UNIVERSITY OF WEST FLORIDA                                                   OFFICER/EMPLOYEE:                                      Pcard user                      HEADQUARTERS:
REQUEST FOR REIMBURSEMENT                                           NON-EMPLOY/IND CONTRACTOR:                                      St. Direct Pd
OF TRAVEL EXPENSES

                                                                                                                   Hour of                                       Per Diem/
                                                                                                                  Departure                         Meals for      Actual     Vicinity
                                Travel Performed From Point                    Purpose or Reason                   Return                           Class A&B     Lodging     Mileage       Map                                           Other Expenses
          DATE                      of Origin to Destination                  (Name of Conference)               xx:xx AM/PM                         Travel      Expense      Claimed     Mileage                           Amount                     Type




Justify Airline                Insert Airline Justification                                                                                                                      0           0
Justify Car                    Insert Car Rental Justification                                                                                       Column      Column      Miles total Miles total                        Column                  SUMMARY
Benefit to State               Insert Benefit to State State
                               Insert Benefit to                 (See list below)                                                                     Total        Total      $0.445      $0.445                              Total                   TOTAL
Statement of Benefits to the
State: (Conference or
Convention                                                                                                                                            $0.00          $0.00       $0.00       $0.00                           $0.00                                 $0.00
Revolving Fund:                                                           Advance:                                                                                                                         LESS ADVANCE RECEIVED
 Check No.                                                                  Warrant No.                                                                                                                    LESS UWF PAID CHARGES $                                   -
 Check Date:                                                                Warrant Date:                                                                                                                       NET AMOUNT DUE *                                   $0.00
 Agency Voucher No.                                                         Statewide Doc. No.                                                                                                                  * If negative, traveler owes UWF
                                                                            Agency Voucher No.
I hereby certify or affirm that the above expenses were actually incurred by me as necessary travel expenses in                      Pursuant to Section of 112.61(3)(A), Florida Statutes, I hereby certify or affirm that to the best of my
the performance of my official duties; attendance at a conference/convention was directly related to official duties                 knowledge the above travel was on official business of the University of West Florida and was performed
of the agency; any meals or lodging included in a conference/convention registration fees have been deducted from                    for the purpose(s) stated above.
this travel claim; and that this claim is true and correct in every material matter and same conforms in every respect
with the requirements of Section 112.061, Florida Statutes.                                                                         Supervisor's Signature:                                                       Title:

TRAVELER'S SIGNATURE:
TRAVELER'S TITLE:                                                                                                                   Date Approved:

DATE PREPARED:
P-CARD CHARGES or UWF DIRECT PAYMENTS
Date               Merchant/Vendor or Agency                                                         Description of Item Acquired                               P-Cardholder Name                                                                  Amt of Charge




Make sure you attach required receipts to this TER for all expenses required by State Law. [Rev.10/27/00]                                                                    TOTAL STATE PAID CHARGES =                               $                              -
FOR AGENCY USE:



                                                                        TRAVEL PERFORMED BY COMMON CARRIER OR UNIVERSITY VEHICLE
                                                THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN COMMON CARRIER IS BILLED DIRECTLY TO THE UNIVERSITY
           Date                Ticket Number or University Vehicle Number            From                     To                                                                                  Amount                   Name of Common Carrier or
                                                                                                                                                                                                                                      Agency owning vehicle

								
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