INTERMEDIATE UNIT 1 - SPECIAL EDUCATION-DAILY TRAVEL EXPENSE VOUCHER - ITINERANT STAFF ONLY
Round up or down all mileage figures to appropriate whole number.
Name Address & Zip Code Type of Program Assignment Location of Assigned Headquarters Date Submitted
Mileage Mileage Mileage Mileage Mileage Mileage
From From From From From From Total Tolls
1st 2nd School 2nd 2nd School 3rd 3rd School 4th 4th School 5th 5th School 6th 6th School 7th (Actual
Travel *School/Station to *School/Station to *School/Station to *School/Station to *School/Station to *School/Station to *School/Station Miles
Date Reported To 3rd School Reported To 3rd School Reported To $th School Reported To 5th School Reported To 6th School Reported To 7th School Reported To Traveled)
Total Mileage x ¢ Per Mile = + Total Tolls = Total Amount Due
* Could be school or any other station to which you reported for work.
1. No personal auto mileage is allowed for travel between the employee's residence and first work station in the A.M. nor from the last work station in the P.M. to the employee's residence.
2. Travel mileage from the assigned headquarters in the A.M. or return travel mileage to the assigned headquarters in the P.M. is allowable only if the employee does in fact report to the assigned headquarters as his first work
station in the A.M. and reports back to the assigned headquarters as his last work station in the P.M. Only actual miles traveled and necessary to perform the functions related to the employee's assignment are reimbursable.
3. Do not submit miscellaneous expenses on this form. For reporting miscellaneous expenses incurred while attending official Board authorized meetings or conventions, obtain a a Miscellaneous Expense Voucher form from your
immediate supervisor or Linda Boor at the Central Office.
4. A falsification of this report in regards to the actual miles traveled according to the above travel reimbursement procedure could subject the employee to suspension or possible dismissal for repeated falsifications.
5. Prepare this form in duplicate. Return original to Linda Boor, Central Office, One Intermediate Unit Drive, Coal Center, PA 15423-9642. Submit so that the form will reach the Central Office by the fifth (5th) day of the month.
6. Attach copy of Phone bill and original Toll Receipts.
To the best of my knowledge this is a true and accurate report of actual miles traveled and other related travel expenses.