State of New Jersey
Department of the Treasury Accounting Bureau
TRAVEL EXPENSE INVOICE
FY FUND AGCY ORGN 074 APU ACTV OBJT REPT C TV Number
Total Amount $ Do you have
Direct Deposit for TRAVEL?
NAME AND ADDRESS OF EMPLOYEE Name/ Street/ City/ State/ Zip Code
Social Security Number
(not payroll)
Yes/No
TE/TH Number
DATE
ITEMS (In Detail)
TRANSPORTATION AUTO OTHER Miles (Specify)
SUBSISTENCE HOTEL MEALS
OTHER MEALS (Specify)
SUNDRIES (Explain Fully)
TOTALS
Miles
@
$0.31
=
$
-
$
-
$
-
$
-
$
GRAND TOTAL
-
$ $
-
EMPLOYEE CERTIFICATION
I certify that the above expenses are correct in all respects; that the distances as charged have been actually and necessarily traveled by me on the dates therein specified; that the amount as charged has been actually paid for by me for traveling expenses; that no part of the account has been paid by the State, but the full amount is due. I also CERTIFY that on the date(s) when the above items of expense were incurred the vehicle I was using on State business was covered by liability insurance as follows:
Travel Form "B" Number Official Station Travel Assignment Class Normal Commute Mileage: Supervisor Approval
Cost:
$
-
SIGNATURE Company: Coverage: Employee's Signature Official Position Approval Officer/ DATE (AUTHORIZED SIGNATURE) APPROVED:
For Administration Division USE ONLY
ATTACH ORIGINAL RECEIPTS WHEN REQUIRED PURSUANT TO STATE TRAVEL REGULATIONS
TV-DOS
Instructions for filling out the Travel Expense Invoice form
*Click on the Travel Expense Invoice tab at the bottom of the screen and fill in the blanks. *Press the Tab key or click on the cell to move to the next blank to fill in *Calculations will be performed automatically *Save the form by clicking on the Save tool; or clicking on File, Save; or holding down the Ctrl key and tapping the S. You will be prompted to save the file using a new file name. *Print using the printer tool on the toolbar or File, Print