Auto Mileage Logs - Excel

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					                                                         University of Oklahoma
                                                  Employee Moving Expense Certification
                    (For further information consult the University's "Payment of Employee Moving Expenses" policy and/or IRS Publication 521)


Purpose: This form is to be used to request reimbursement of employee incurred moving expenses and payment of moving expenses directly to third parties by
the University. All requests for these payments must be accompanied by sufficient supporting documentation (e.g., original invoices, mileage logs, etc.) and
submitted to Financial Support Services, EH, Room 303. This form is also to be used to report to Payroll and Records, NEL, Room 244, and the employee all
related moving expense payments made directly to third parties by the OU Foundation.

Important: In order for the employee's qualified moving expenses to be nontaxable, the move must be closely related to the start of work (within one year). The
move must also meet a distance test which requires that the new job location is at least 50 miles farther from the former residence than the old job location.

Qualified expenses are those incurred for the moving of household goods and personal effects of the employee and the employee's household from the
employee's old residence to the new residence and in traveling (including lodging but not meals) from the employee's old residence to the new residence.
Payments made by the University or the OU Foundation for qualified moving expense are nontaxable and will be reported as such on the employee's W-2.

Nonqualified expenses are those incurred by the employee and their household for meals, pre-move househunting trips, temporary living in the general area
of the new workplace, costs involved with selling and buying a new residence, and any other costs associated with the relocation. Payments made by the
University or the OU Foundation for nonqualified expense are taxable and will be reported as income on the employee's W-2.


PART I: DEPARTMENT                   NAME OF EMPLOYEE:                                                                      SSN:

                                     UNITED STATES CITIZEN:          YES               NO                   (please check applicable box)

                                     COUNTRY OF RESIDENCE:                                                  (complete if not a United States citizen)

                                     DEPARTMENT:                                       BILLING ACCT:                                       PHONE:


PART II: MOVING EXPENSE                 QUALIFIED EXPENSES                                  EMPLOYEE              PAID TO            PAID BY OU

                                      (Nontaxable, W-2 Box 13)                           REIMBURSEMENT           3RD PARTY          FOUNDATION            TOTAL
                                     Moving Van Line                                                                                                              $0.00
                                     Rental Truck or Trailer                                                                                                       0.00
                                     Storage costs (up to 30 days)                                                                                                 0.00
                                     Airfare (final move)                                                                                                          0.00
                                     Lodging (but not meals)                                                                                                       0.00
                                     Auto expenses - actual cost                                                                                                   0.00
                                     or ____ total miles x $0.165 (16.5 cents)                                                                                     0.00
                                     Other (please explain):                                                                                                       0.00
                                     Other (please explain):                                                                                                       0.00
                                              SUBTOTAL                                             $0.00                $0.00               $0.00                $0.00

                                     NONQUALIFIED EXPENSES                                  EMPLOYEE              PAID TO            PAID BY OU

                                     (Taxable, W-2 Box 1, 3, 5 & 12)                     REIMBURSEMENT           3RD PARTY          FOUNDATION            TOTAL
                                     Pre-Move Expenses:                 Airfare                                                                                   $0.00
                                                                      Travel                                                                                       0.00
                                                                      Lodging                                                                                      0.00
                                     Meals                                                                                                                         0.00
                                     Temporary Quarters                                                                                                            0.00
                                     Auto expenses in excess of $0.335 per mile                                                                                    0.00
                                     Other (please explain):                                                                                                       0.00
                                     Other (please explain):                                                                                                       0.00
                                              SUBTOTAL                                             $0.00                $0.00               $0.00                $0.00

                                          TOTAL EXPENSES                                           $0.00                $0.00               $0.00                $0.00

PART III: EMPLOYEE                   I understand that all "nonqualified" moving expenses paid by the University of Oklahoma either directly to a third party
          ACKNOWLEDGMENT             and/or directly to me are considered wages for W-2 purposes. The total amount of such payments will be included in my
                                     W-2 in the calendar year in which they were paid and the University is required to withhold federal and state income tax
                                     and FICA on these amounts.


                                     EMPLOYEE SIGNATURE:_____________________________________________________ DATE:___________________



PART IV: AUTHORIZATION               ACCOUNT SPONSOR APPROVAL:_____________________________________________ DATE:___________________

				
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