Reimbursment Form - State Bar of Texas.xls by liningnvp

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									                                                             STATE BAR OF TEXAS
                                                        Request for Reimbursement of Expenses


                                                                                                                                    Date of Request
PURPOSE OF TRAVEL:                                                                  Reimbursement Requests must be forwarded to the
                                                                                    appropriate authorizing department for processing.
                                          From                To
                                                                                    PLEASE SEE BELOW FOR A LIST OF APPLICABLE
Date(s) of meeting                                  -                               DEPARTMENTS
Date(s) of travel                                   -
Location of meeting                                                                 Please complete areas highlighted in GREEN


                                                                                           STATE BAR APPROVAL
MAKE CHECK PAYABLE TO:
                                                                         Date Approved for Payment:_______________________________, 20______
(Name of Individual, Firm , or Company)
Barcard # (if appicable)                                                 __________________________________________________________________
Name                                                                     (Officer, Committee Chair, Executive, Dept. Head, Other)
Street Address
                                                                         __________________________________________________________________
                                                                         Finance Department
City, State and Zip
Telephone Number




MEETINGS AND TRAVEL EXPENSE
                              Transportation Items and Descriptions                                                                     AMOUNT
Airfare                                      $          -                                                                 $                                    -
Speaker Airfare (TxBarCLE use only)          $          -                                                                 $                                    -
Car Rental & Fuel                            $          -                                                                 $                                    -
Taxi / Limo Service                          $          -                                                                 $                                    -
                                                             (0.51 Before Jul 1, 2011
Parking & Tolls                              $          -                                                                 $                                    -
Auto Mileage
                                                             )
                                                            @ $        0.555 ===========>                                 $                                    -
Other                                        $          -   (Enter Description Here)                                      $                                    -
                                                                                                   Travel Subtotal         $                               -
                                      Lodging and Meals Items and Descriptions                                                         Daily Total
              Date                                         Hotel            Meals                      Non-Dues
                                                      $          -       $       -                    $      -
                                                      $          -       $       -                    $      -
                                                      $          -       $       -                    $      -
                                                      $          -       $       -                    $      -
                                                      $          -       $       -                    $      -
                                                      $          -       $       -                    $      -

Lodging & Meals Subtotal                                 $          -       $         -               $            -       $                               -
                                    Expenses Not Related Travel, Lodging, or Meals
Description                                                                 $         -                                    $                               -
                      ***** For State Bar Use Only *****                     $                -      <======>              $                               -
    FUND-DEPT-ACCT                   LOCATION                 MDA                TOTAL                                  Total Reimbursment Requested
                         --50200-                   -                       $         -
                         --50205-                   -                       $         -
                         --50210-                   -                       $         -
                                                                                                                   CERTIFICATION OF CLAIMANT
                         --50215-                   -                       $         -
                         --50220-                   -                       $         -                   The above described expenses were incurred by me
                         --50225-                   -                       $         -                   for the purpose stated. I have attached receipts for
                                                                                                          applicable expenditures (airlines, hotels, etc.), except
                         --50230-                   -                       $         -                   in cases where receipt has been lost. I certify that this
                                                                                                          request is true, correct, and unpaid.
                         --50252-                   -                       $         -
                         --50285-                   -                       $         -
                                                    -                       $         -
                                                                                                          ___________________________________________
                                                    -                       $         -                   Signature of Claimant              Date
                                                    -                       $         -

Enter Fund Code                                         Enter Location
Enter Dept Code                                         Enter MDA
                                            STATE BAR OF TEXAS
                                        Request for Reimbursement of Expenses




                     State Bar of Texas
                                                              Reimbursements for approved Board of Directors
                     Officers & Directors Department
                                                              related business, meetings and functions
                     P.O. Box 12487
Board of Directors
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request

                     State Bar of Texas
                                                              Reimbursements for approved State Bar committee
                     Committees Department
                     P.O. Box 12487                           business, meetings and functions.
Committees
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request


                     State Bar of Texas                       Reimbursements for qualified/approved State Bar
                     Sections Department                      Section, business, meetings and functions.
Sections             P.O. Box 12487
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request

                     State Bar of Texas                      Reimbursements for approved Commission for
                     Chief Disciplinary Counsel              Lawyer Discipline and Chief Discplinary Counsel
Chief Disciplinary   P.O. Box 12487                          Office business and meetings.
Counsel              Austin, Texas 78711-2487
                     Attn: Reimbursement Request



                     State Bar of Texas
                     TYLA Department                          Reimbursements for approved TYLA business,
                     P.O. Box 12487                           meetings and functions.
TX Young Lawyers
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request



                     State Bar of Texas
                     TexasBarCLE Department                   Reimbursements related to TexasBarCLE program
                     P.O. Box 12487                           business, speakers, etc.
TexasBarCLE
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request



                     State Bar of Texas
                     Accounting Department                    Reimbursements for approved State Bar employe
                     P.O. Box 12487                           business expenses, meetings, travel, etc.
SBOT Employees
                     Austin, Texas 78711-2487
                     Attn: Reimbursement Request



                     State Bar of Texas
                     Texas Bar Books                          Reimbursements for approved Texas Bar Books
                     P.O. Box 12487                           business expenses, meetings, travel, etc.
Texas Bar Books
                     Austin, Texas 78711-2487
                     Attn: Reimbursements
                                                    STATE BAR OF TEXAS
                                               Request for Reimbursement of Expenses

                            Reimbursement forms should be first
                            forwarded to your appropriate District
                            Subcommittee Chair for approval and
                            signature,. Then send the form to: UPLC, P.O.
                            Box 12487, Austin, TX 78711-2487 or                  Reimbursements for approved UPL Committee
Unauthorized Practice of
                            zara.munoz@texasbar.com. The form will then          business expenses, meetings, travel, etc.
Law Committee
                            be reviewed for approval by the Chairman of
                            the UPLC.




Texas Board of Legal       Odessa Bradshaw
Specialization             TBLS, Associate Executive Director               Reimbursements for approved TBLS business expenses ,
                           505 E. Huntland Dr., Ste. 400, LB 28             meetings, travel, etc.
                           Austin, TX 78752




                            Law Related Education                                Reimbursements for approved Law Related
Law Related Education       P.O. Box 12487                                       Education business expenses , meetings, travel,
Department                  Austin, TX 78711-2487                                etc.
                            Attn: Reimbursement Request




                           College of the State Bar of Texas                       Reimbursements for approved College of the
                            P.O. Box 12487                                         State Bar business expenses, meetings,
                           Austin, TX 78711-2487                                   travel, etc.
College of the State Bar        Attention: Merianne Gaston


Minority Affairs           Minority Affairs                                     Reimbursements for approved Minority Affairs business
                           State Bar of Texas                                   expenses, meetings, travel, etc.
                           P.O. Box 12487
                           Austin, TX 78711-2487
                 STATE BAR OF TEXAS
              Request for Reimbursement of Expenses




 ), except
y that this
   STATE BAR OF TEXAS
Request for Reimbursement of Expenses
                                                           STATE BAR OF TEXAS
                                                        Request for Reimbursement of Expenses

                                                                                                                           8/1/2012
                                                                                                                        Date of Request
PURPOSE OF TRAVEL:
Vendor Meeting                                                              Reimbursement Requests must be forwarded to
                                                                            the appropriate authorizing department for
                                  From                  To                  processing.
Date(s) of meeting           4/30/2009         - 5/12/2009
Date(s) of travel            4/30/2009         - 5/12/2009                  PLEASE SEE BELOW FOR A LIST OF
Location of meeting          Dallas, Texas                                  APPLICABLE DEPARTMENTS


                                                                                        STATE BAR APPROVAL
MAKE CHECK PAYABLE TO:
                                                                     Date Approved for Payment:_______________________________, 20______
(Name of Individual, Firm , or Company)
Barcard # (if appicable)       01234567                              __________________________________________________________________
Name                         John Q. Public                          (Officer, Committee Chair, Executive, Dept. Head, Other)
Street Address               1414 Colorado Street                    __________________________________________________________________
                             STE 666                                 Finance Department
City, State and Zip          Austin, Texas 78701
Telephone Number




MEETINGS AND TRAVEL EXPENSE
                         Transportation Items and Descriptions                                                              AMOUNT
Airfare                                 $     1,200.00                                                      $                                1,200.00
Speaker Airfare (TxBarCLE use only)     $       100.00                                                      $                                  100.00
Car Rental & Fuel                       $       300.00                                                      $                                  300.00
Taxi / Limo Service                     $         8.00                                                      $                                    8.00
                                                           (0.585 Before Jan 1, 2009
Parking & Tolls                         $        50.00                                                      $                                   50.00
Auto Mileage                                        30 @ $
                                                           )        0.550 ===========>                      $                                   16.50
Other                                   $        25.00 (Enter Description Here)                             $                                   25.00
                                                                                      Travel Subtotal       $                            1,699.50
                                Lodging and Meals Items and Descriptions                                                   Daily Total
           Date                                      Hotel            Meals              Non-Dues
              4/30/2009                         $       100.00     $     50.00          $     25.00
               5/1/2009                         $       100.00     $     50.00          $       -
               5/2/2009                         $       100.00     $     50.00          $     25.00
               5/3/2009                         $       100.00     $     50.00          $       -
               5/4/2009                         $       100.00     $     50.00          $     25.00
               5/5/2009                         $          -       $     50.00          $       -
Lodging & Meals Subtotal                            $       500.00   $     300.00       $         75.00     $                               875.00
                              Expenses Not Related Travel, Lodging, or Meals
Description                                                          $          -                           $                                     -
                    ***** For State Bar Use Only *****               $ 2,574.50 <======>                    $                            2,574.50
 FUND-DEPT-ACCT                 LOCATION                 MDA             TOTAL                              Total Reimbursment Requested
          1-2222-50200-                        -                     $    1,200.00
          1-2222-50205-                        -                     $     500.00
          1-2222-50210-                        -                     $     300.00
                                                                                                      CERTIFICATION OF CLAIMANT
          1-2222-50215-                        -                     $         8.00
          1-2222-50220-                        -                     $     300.00           The above described expenses were incurred by me for the
          1-2222-50225-                        -                     $      16.50           purpose stated. I have attached receipts for applicable
                                                                                            expenditures (airlines, hotels, etc.), except in cases where
         1-2222-50230-                         -                     $      50.00           receipt has been lost. I certify that this request is true,
                                                                                            correct, and unpaid.
         1-2222-50252-                         -                     $      75.00
         1-2222-50285-                         -                     $     100.00
         01-2222-66666                         -                     $      25.00
                                                                                            _______________________________ _______________
                                               -                     $        -             Signature of Claimant              Date
                                               -                     $        -
                                               -                     $        -
                                               -                     $        -
                                                   STATE BAR OF TEXAS
                                            Request for Reimbursement of Expenses

Enter Fund Code                   01     Enter Location
Enter Dept Code                 2222     Enter MDA




Board of Directors    State Bar of Texas
                                                              Reimbursements for approved Board of Directors
                      Officers & Directors Department
                                                              related business, meetings and functions
                      P.O. Box 12487
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request

Committees            State Bar of Texas
                      Committees Department                    Reimbursements for approved State Bar
                      P.O. Box 12487                           committee business, meetings and functions.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request

Sections              State Bar of Texas
                      Sections Department                      Reimbursements for qualified/approved State Bar
                      P.O. Box 12487                           Section, business, meetings and functions.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request

Chief Discpl. Cnsl.   State Bar of Texas
                      Chief Disciplinary Counsel               Reimbursements for approved Commission for
                                                               Lawyer Discipline and Chief Discplinary Counsel
                      P.O. Box 12487
                                                               Office business and meetings.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request


TX Young Lawyers      State Bar of Texas
                      TYLA Department                          Reimbursements for approved TYLA business,
                      P.O. Box 12487                           meetings and functions.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request


TexasBarCLE           State Bar of Texas
                      TexasBarCLE Department                   Reimbursements related to TexasBarCLE
                      P.O. Box 12487                           program business, speakers, etc.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request


SBOT Employees        State Bar of Texas
                      Accounting Department                    Reimbursements for approved State Bar employe
                      P.O. Box 12487                           business expenses, meetings, travel, etc.
                      Austin, Texas 78711-2487
                      Attn: Reimbursement Request




                                           WHERE TO SEND
                                               YOUR
                                           REIMBURSEMENT
                                              REQUEST
                          STATE BAR OF TEXAS
                       Request for Reimbursement of Expenses



            1/1/2009




e for the

								
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