UNIVERSITY OF CALIFORNIA, BERKELEY
School of Social Welfare 120 Haviland Hall, MC 7400
REQUEST FOR TRAVEL EXPENSE REIMBURSEMENT
PLEASE: Attach plane tickets stubs, itinerary (even if University has prepaid), conference agenda, and other required receipts. Receipts/statement should indicate zero balance. Request should be submitted within ten (10) days of completion of travel. Name:
Visitors & Students – Please provide SSN # or SID #
Date:
Mailing Address for Check: Destination: Purpose of Trip:
Transportation Airfare Hotel Taxi Shuttle Parking Tolls Car Rental $ $ $ $ $ $ $
Cost
Between What Points
Date
For mileage reimbursement: Indicate car license number: Total trip mileage: City of origin and return: Please complete any of the miscellaneous following items applicable to travel. Cost Meals * Telephone/Internet Registration Fee(s) Other $ $ $ $ City Date
* Total meal and incidental allowance for domestic travel is $50 per day. Receipts should reflect payment for one person, or provide explanation. Per travel policy, if you are claiming reimbursement for miscellaneous expenses a written explanation is required to justify business reason for expense (please write brief explanation on back of form). If foreign travel per diem is requested, please provide on a separate sheet more information identifying whether days were personal or business.
Traveler’s Signature
Date
Department Approval Chartstring: Fund Org Code Prg Project
Date
Flex
4/10/08