mileage expense voucher _08-34_

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mileage expense voucher _08-34_ Powered By Docstoc
					                                           UNIVERSITY OF CALIFORNIA, SAN DIEGO
                                          PRIVATE AUTOMOBILE MILEAGE VOUCHER
                                                (Use when mileage is the only travel expense)

        Yes     I have read the personal notification statement posted on the Forms page of the Travel web site.

For current mileage rates, see the travel web site at

Date:                                                     Page:           _____of_____                     Accounting Office Use Only
Make Check Payable To & mailing Address:                  License No:                                          Document Number

Social Security Number:                                   Vehicle                                  Year:
                      Location Visited                                 Date(s)           Mileage      Rate          Reimbursement Claimed



                                                                                                           Total:                  $0.00
Purpose of Trip:

Other Employees Transported:

I certify that the above is a true statement of the travel expenses incurred by me in the service of the University of California
during the date(s) shown on the face of this claim, that all items were for the official business of the University of California,
and that the vehicle used was covered by the minimum liability insurance required by university travel regulations.*
Prepared By:                                Extension:                    Claimant's Signature:

*$15,000/Personal Injury or Death of one person                           Approved by: (Authorized Signature)
 $30,000/injury or death of two or more persons in one accident
 $5,000/property damage
Business Office Approval:

                              Required when mileage is claimed beyond local county areas without prior approval
                              (San Diego, Orange, Los Angeles, Riverside and Imperial Counties (PPM 365-2)
              INDEX                      FUND                     ACCOUNT                                                 AMOUNT

UC San Diego - F02053
Retention: 5 years subject to Federal Contract or Grant Requirements