Form M - Travel Reimbursement Meals, Mileage, Tolls by mvc12731

VIEWS: 7 PAGES: 1

									                                                                                                                                                         Print Form

                                                                    Form M - Travel Reimbursement
                                                      Meals, Mileage, Tolls, Parking and Train/Subway Fares(Only)

Name                                                         Employee ID                                 Department

Collective Bargaining Unit                                                           Mileage rate is .55 per mile.                        Type (1)          Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

Date                   Description                                                    Mileage                 Amount

(1) Please indicate in drop down menu applicable category M - Meals; T - Tolls; P - Parking;                  Total A                          Total B
    Fares (Train/subway) (Receipts required)
Chartfield
                                                                                                                      Grand Total (A+B)
  Account       Fund                 Department   Program   Grant/Project

                                                                                 Grant         Project       FINANCIAL SERVICES USE ONLY

                                                                                                              Voucher No.
Travellers Certification: I hereby certify under penalty of perjury that the above amounts as itemized
are true and correct, were incurred by me during necessary travel in the service of the Commonwealth,         Vendor No.
and conform fully with the travel rules and regulations.
                                                                                                              Schedule Date
Traveler                                                           Date
                                                                                                              Entered by:
Manager                                                            Date
Revised: 10.16.2009                                                                                           Invoice

								
To top