Arkansas School for Mathematics, Sciences & the Arts
REQUEST FOR AUTHORIZATION OF TRAVEL EXPENSES (TA)
Authorization #: _________________
Name: ID#: Dept: Date:
Purpose: No Cost-ASMSA Insurance Only
Date Leaving: Date Returning:
Official Business Start Date: Official Business End Date:
EXPECTED TRAVEL EXPENSES
To be paid by:
TRANSPORTATION: Traveler ASMSA
Personal Auto School Auto Guest in Car
From (City, State): NA NA
To (City, State):
City of Residence:
Air (Preferred travel times MUST be attached)
Rental Car (MUST be approved by Director) Special Requirements:
REGISTRATION: Already Registered Need to be registered Deadline:
BOOTH RENTAL & ACCESSORIES: Already Reserved Needs to be Reserved Deadline:
LODGING: (Lodging contact information MUST be attached) Deadline:
MEALS: (Original, itemized receipts MUST be provided) NA
INCIDENTALS: (Taxi, Parking, Phone, Internet, Etc.) NA
OTHER: Please specify
FOR FINANCE USE ONLY
(F) _______________ (O) _______________ (A) _(see below)______ (P) ________________
To:________________________ BTA Prepaid Reimb
VEHICLE From: __________________________ =
From: __________________________ =
From: __________________________ =
# of Miles ________________ X Rate ______________________ 7410
AIR FARE Payable To: ___________________________________________________ 7420
RENTAL CAR 7470
REGISTRATION Payable To: ___________________________________________________ 7450
BOOTH RENTAL & ACCESSORIES Payable To: _____________________________________ 7455
LODGING Per Diem $ ______ Actual $_______________ X Days __________ + 20% 7400
MEALS Per Diem $ ______ $_______________ X Days __________ / 2 7400
GUEST OF STATE 7440
REQUEST FOR SPECIAL AUTHORIZATION: Lodging maximum is exceeded or rental car is requested. Justification required. GRAND TOTAL:
Travel Administrator (Director) Approval:_______________________________________________________ $_________________
Budgetary Head:_____________________________________________________________________________ Date:
Senior Administrator:_________________________________________________________________________ Date:
Travel Administrator (Director):________________________________________________________________ Date:
Travel Supervisor (Finance):___________________________________________________________________ Date:
Summary for your trip
Please keep this information for your records and DO NOT turn it in with your TA.
Trip To: 0 1/0/1900 thru 1/0/1900
You have indicated that your travel will start on 1/0/1900 and end on 1/0/1900
We will use these dates to determine flight & lodging arrangements unless specified otherwise.
Your actual official school business will start on 1/0/1900 and end on 1/0/1900
These dates may not necessarily be the same as your travel dates. These dates indicate when your conference, meeting
etc. will actually take place. It may be necessary to travel a day before and/or after your official business dates.
This information is based on the combination of check boxes that you selected in the "Expected Travel Expenses" section. Please review and
change your check boxes as necessary.
Vehicle: Because you did not check a vehicle box, you have indicated that you will not be using a vehicle during this trip. You DO NOT need
to complete the 'Travel by Personal Auto' section of the TR-1.
Flight: Because you did not check Air, you have indicated that you will NOT need a flight for this trip.
No flight arrangements will be made for this trip.
Rental Car: Because you did not check Rental Car, you have indicated that you will NOT need one for this trip.
No rental car arrangements will be made for this trip.
Registration: Because you did not select a registration method, you have indicated that registration is not needed for this trip.
No registration arrangements will be made for this trip.
Booth Fees: Because you did not select a booth reserv method, you have indicated that a booth is not needed for this trip.
No booth reservations will be made for this trip.
Lodging: Because you did not select a payment method for lodging, you have indicated that you do not need lodging.
Meals: Because you did not select a meals payment method, you have indicated that you do not expect to have to purchase any meals on
Incidentals: You do not expect to have incidental charges during your trip.
Other: You do not expect to have any other expenses that are not already outlined.
Please make sure you have completed ALL highlighted fields that are applicable to your trip.
If you are seeking reimbursement for any expenses related to this trip, you MUST have your TR-1 completed within 30 days of your return date!