Employee Checkout Instructions

							           1/29/2011


                                                       SALEM CITY SCHOOLS
                                          Travel Expense Reimbursement Form (Post-Travel)
Instructions: Please fill in yellow cells and submit with ORIGINAL RECEIPTS within 5 days of return from trip.
Use TAB key to fill in all applicable yellow cells.
Costs must be entered for each day individually to meet IRS requirements                                                        mm/dd/yyyy

Employee Name:                                                                                      Date Prepared:
Purpose of Travel:
Location of Event (City/State)
                                                                       Actual Costs Incurred:
                                 Sunday   Monday         Tuesday       Wed       Thurs      Friday                 Saturday Totals
1) Enter Dates of Travel
as mm/dd/yyyy

2) Registration

3) Meals                                                                                                                                 $0.00

4) Lodging                                                                                                                               $0.00

                                                                                    Enter total #
5) Mileage in personal                                                              of miles to
vehicle to be reimbursed                                                            be
at $.42/mile                                                                        reimbursed:                        $0.42             $0.00
5.5) Air Fare                                                                                                                            $0.00
6) Rental Car and Rental
car gas                                                                                                                                  $0.00
7) Parking                                                                                                                               $0.00
8)Tolls                                                                                                                                  $0.00
9) Taxi, Shuttle, Subway                                                                                                                 $0.00
10) Baggage Handling                                                                                                                     $0.00
Expenses not listed above--
please describe in notes line
below                                                                                                                                    $0.00
Notes:                                                                                                                                   $0.00
Total Cost of Event and Travel                                                                                        (a)                $0.00
Less: amounts already paid by school division (ENTER AS NEGATIVE NUMBER)                                              (b)
Net amount of travel reimbursement due to employee                                                                 (a -b)   $           $0.00
Account Number:
By signing below, the employee certifies that the travel costs were incurred for valid school division purposes.
Employee Signature                                                                                     Date

Instructions: (Enter data in yellow cells as applicable)
(1) Enter date as mm/dd/yyyy and each day's costs individually
(2) Enter the amount of registration, whether prepaid or not. Attach original receipt if not previously submitted.
(3) Meal per diems are Breakfast $9, Lunch $9, Dinner $18 or $36 per day except a maximum of $27 per day
 (.75 x $36) on date of departure and date of return-no receipts required- includes meal tips
No meal reimbursments are allowed for day trips, only overnight trips--per IRS regulations.
(4) Must attach an original hotel receipt received at checkout
(6) Attach rental car original receipt and gas receipts
(7) Attach receipt if cost per day of parking is over $10
(9) Attach receipt for any item over $15