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					                                                                             P.O. Box V-38 ∙ Palo Alto, CA 94304-0038

                                      TRAVEL REIMBURSEMENT REQUEST

      Today's Date:                   Traveler:                                   Payee, if different:
 Date of Departure:                         Place of Departure:
    Date of Return:                            Place of Return:
   Meeting/Conference/Business:
          Location of Conference:
                        Relevance:
      Leave Status if paid by VA:            Auth. Absence        Annual Leave        Leave without Pay         OR :       Not VA paid

       Attach original receipts for all expenses except per diem claim or taxi/shuttle costs less than $25 per trip.
Registration Fees:
 Travel Expenses: $           -         (Calculated from the amounts entered below in the column on the right.)
                                        Airfare:
                                        Taxi/Shuttle:
                                        Rental Car and Associated Gas Purchases:
                                        Personal Vehicle:                    Miles @ $0.500 /mile                      $           -
                                        Parking:
                                        Lodging:
                                        Meals & Incidentals        Look up per diem rates on the Web
                                      It is the traveler's responsibility to deduct per diem reimbursement
                                              for any meals provided in association with this travel.

                                            Per Diem:                    -   Whole Days @                /day          $           -

                                            First & last day            2     Days @ 75% of per diem                   $           -
                                       Or
                                            Actual Expenses (attach receipts)

                                        Other (describe):

    Total:      $             -


I certify that the information provided is accurate and that I have not
claimed duplicate reimbursement from any other entity.
                                                                                  Signature of Traveler, if not P.I.

                       Please call:                                     at ext.                  when check is ready for pickup.
                    Please mail to:



PAIRE Investigator's Signature                                                    PAIRE Account (10 Characters)



     05/05/09                                   Phone: 650.858.3970 ∙ Fax: 650.858.3907
This sheet has the explanations and instructions which are linked from the form page.

Travel Reimbursement Request - General information                    Return to reimbursement form
-This form is meant to be filled out online. If you prefer to print the form and fill it in
  manually or by typewriter, please use the pdf version of this document which is
  available on the Forms page of the PAIRE website at:                PAIRE.org Forms page
-Note that all fillable fields use "shrink to fit" so don't worry that your text is too long.
-It is highly recommended that you read PAIRE's             Travel Policy
-If it appears that PAIRE is only paying some of the travel expenses we will ask for an explanation.

Today's Date:                                         Return to reimbursement form
The date when you fill out the form. Should be within 30 days of travel.
Claims submitted more than 60 days after travel is completed may be denied.

Traveler:                                                Return to reimbursement form
Enter the name of the person who took the trip.

Payee, if different:                                    Return to reimbursement form
This may not be the traveler. Sometimes a supervisor or co-worker pays for other peoples' expenses,
or payment is to be made to a travel agent or hotel directly. PAIRE payment directly to an airline
is not recommended because of airlines' right to request traveler to show the credit card used.

Date of Departure:                                       Return to reimbursement form
Adjust to first day of business travel if personal time was taken at the beginning of the trip.

Place of Departure:                                  Return to reimbursement form
Usually traveler's home or workplace. (Used to calculate personal vehicle expense.)

Date of Return:                                         Return to reimbursement form
Adjust to last day of business travel if personal time was taken at the end of the trip.

Place of Return:                                     Return to reimbursement form
Usually traveler's home or workplace. (Used to calculate personal vehicle expense.)

Meeting/Conference/Business:                          Return to reimbursement form
Enter the name of the meeting or conference, or a short explanation of the business trip. Provide
documentation in the form of a program or print out of web page; or email/letter about the business trip.

Location of Conference:                                Return to reimbursement form
Enter the City and State (& Country, if outside U.S.) or address if this is for local travel.

Relevance:                                          Return to reimbursement form
The traveler must submit adequate information or documentation to justify a primary research or
education purpose for the travel.

Leave Status if paid by VA:                            Return to reimbursement form
VA-paid employees traveling on PAIRE funds should be on VA travel status or authorized absence
(including Stanford-supported sabbatical leave) to receive reimbursement for travel expenses.

    05/05/08                                         Page 2 of 6
OR:                                                    Return to reimbursement form
Please check the "Not VA paid" box if that is the case to clarify the need for Leave Status info.

Attach original receipts…                             Return to reimbursement form
Copies and faxes are not acceptable for travel reimbursements.
Note that PAIRE always needs both the itemized detail and proof of payment.

Registration Fees                                       Return to reimbursement form
Include all fees for registration except optional payments made for purely social events or spouses.

Travel Expenses                                         Return to reimbursement form
The online form should calculate the total and enter it on the left.

Airfare:                                                Return to reimbursement form
Include all taxes and fees, including those charged by travel agent or online booking service.
Attach itinerary/receipts showing dates & times as well as proof of payment.

Taxi/Shuttle:                                            Return to reimbursement form
Limited to travel to and from the departure city airport; from airport to hotel; and from hotel to airport.
Once the traveler has arrived at the hotel, taxis will not ordinarily be reimbursed. Excessive taxi
costs will not be reimbursed if the traveler elected to forego reasonable less expensive transportation.

Rental Car and Associated Gas Purchases:                 Return to reimbursement form
Allowed when this is the most cost/time efficient.

Personal Vehicle:                                         Return to reimbursement form
Enter the number of miles to be reimbursed and the form will calculate the dollar amount, by
multiplying the number of miles by the current mileage reimbursement rate. This rate changes
annually on January 1st. For travel to and from the airport, attach an internet map (e.g., Yahoo,
Mapquest, GoogleMaps) showing the distance from your home. Don't forget that if your spouse
drops you off at the airport it's 4 times the mileage (2 round trips).

Parking:                                            Return to reimbursement form
Airport parking will be reimbursed up to the maximum rate in effect at SFO or SJC for the long term lot , not
to exceed a period of six days.

Lodging:                                                Return to reimbursement form
Reasonable standard hotel room costs as determined by the meeting site and prevailing hotel rates.
Business related long-distance telephone calls should be kept to a minimum.
Computer connection fees should be used judiciously.
Personal long distance telephone calls are usually limited to one per day and should be reasonable.




    05/05/08                                         Page 3 of 6
Meals & Incidental Expenses                             Return to reimbursement form
Enter the number of days and the rate for the city or county and the form will calculate the amount.
PAIRE pays per diem at the current GSA (or US State Department for foreign travel) rate for the area.
Tips and travel to meals are considered "incidentals", so separate claims should not be made for
those expenses if the per diem is taken.                Domestic Per Diem Rates
First & last days are paid at 75%.                      Foreign Per Diem Rates
Per diem and actual meal/incidental expenses may not be mixed within a single trip.

It is the traveler's responsibility to deduct per diem reimbursement …     Return to reimbursement form
For each meal provided in association with your travel (e.g., lunch provided at a conference), deduct the
meal's per diem amount from the total per diem that you claim. You can determine the meal's per diem amount
by consulting the Meals and Incidental Expense Breakdown on the GSA website.
                                                                           Meals & Incidentals Breakdown


Actual Expenses                                        Return to reimbursement form
If the traveler elects reimbursement for actual meal & incidental expenses instead of the per diem then
receipts are required for meal purchases, and tips should be itemized on a separate sheet.
In all cases expenses must be reasonable.

Other (describe):                                     Return to reimbursement form
Enter descriptions and amounts of other reasonable travel related expenses and attach receipts.

Total                                                   Return to reimbursement form
Form will calculate the total.

Signature of Traveler, if not P.I.                       Return to reimbursement form
If the traveler is not the person signing the form, s/he must print the completed form and sign here.

Please call:                                             Return to reimbursement form
If the check is not to be mailed, enter the name of the person who should be called to pick it up.

at ext.                                               Return to reimbursement form
Enter the VA phone extension of the person to be called.

Please mail to                                          Return to reimbursement form
If the check should be mailed, enter the address of the payee listed above.

PAIRE Investigator's Signature                        Return to reimbursement form
The form should be printed then signed by the PI or other authorized signer.

PAIRE Account (10 Characters)                       Return to reimbursement form
Enter the number of the PAIRE account paying for the travel.




    05/05/08                                        Page 4 of 6
05/05/08   Page 5 of 6
                                                                               P.O. Box V-38 ∙ Palo Alto, CA 94304-0038

                      TRAVEL REIMBURSEMENT REQUEST--ONLINE VERSION

      Today's Date:    4/28/08        Traveler:          Aaron Aardvark             Payee, if different:            Zita Zebra

 Date of Departure:    4/1/2008             Place of Departure:                      123 park Place, Palo Alto, CA

    Date of Return:    4/5/2008                Place of Return:                      123 park Place, Palo Alto, CA
   Meeting/Conference/Business:         Society of Research Administrators Annual Meeting
          Location of Conference:       Pittsburgh, PA
                       Relevance:       Sessions relevant to all aspects of research administration
      Leave Status if paid by VA:            Auth. Absence        Annual Leave           Leave without Pay      OR :       Not VA paid

       Attach original receipts for all expenses except per diem claim or taxi/shuttle costs less than $25 per trip.
Registration Fees: $      200.00
 Travel Expenses: $ 1,141.29            (Calculated from the amounts entered below in the column on the right.)
                                        Airfare:                                                                       $         345.00
                                        Taxi/Shuttle:                                                                  $          32.00
                                        Rental Car and Associated Gas Purchases:
                                        Personal Vehicle:            36.00    Miles @ $0.505 /mile                     $          18.18
                                        Parking:               Spouse parked at airport for pick-up                    $             3.00
                                        Lodging:                                                                       $         575.11
                                        Meals & Incidentals        Look up per diem rates on the Web
                                        It is the traveler's responsibility to deduct per diem reimbursement
                                                for any meals provided in association with this travel.

                                            Per Diem:                     3    Whole Days @ $ 54 /day                  $         162.00

                                            First & last day              2     Days @ 75% of per diem                 $          81.00
                                       Or
                                            Actual Expenses (attach receipts)
                                                                  Per diem value of breakfast ($10) and lunch
                                        Other (describe):         ($15) provided at conference - 3 days                $         (75.00)

    Total:     $        1,341.29


I certify that the information provided is accurate and that I have not
claimed duplicate reimbursement from any other entity.
                                                                                    Signature of Traveler, if not P.I.

                       Please call:          Connie Courteous             at ext.        12345       when check is ready for pickup.
                   Please mail to:

                                                                                     A    B      C    0    0    1      2    A    R     G
PAIRE Investigator's Signature                                                      PAIRE Account (10 Characters)



     4.28.05                                    Phone: 650.858.3970 ∙ Fax: 650.858.3907

				
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