Employee ID*
Employee Name*
Trip / Activity Description*
Department Name
Fund
Function
Object
Project
Date Expenses Incurred
to

EXPENSE DESCRIPTION

Fund Function Object Project

AMOUNT

1. Meeting/Conference Registration
7631-General
7635-Fac/Dev
$
2. Lodging
7632-General
7633-Rcrt/Guest
7636-Fac/Dev
$
3. Meals
7632-General
7633-Rcrt/Guest
7634-NonTravel
7636-Fac/Dev
$
4. Transportation
7632-General
7633-Rcrt/Guest
7636-Fac/Dev
$
5. Mileage/Personal Vehicle
Miles @ 0.475
7632-General
7633-Rcrt/Guest
7636-Fac/Dev
$
6. Supplies
7720-Program
7721-Athletic
7724-General
$
7. Other Expenses Add Row Delete Row
$
8. Agency Expenses
10-            -2590 ID
$
9. TOTALS $
10. LESS CASH ADVANCE
AMOUNT RECEIVED
10-            -1330 ID
$
11. TOTAL DUE EMPLOYEE $
12. TOTAL DUE UNIVERSITY Attach Payment $
CHECK DISTRIBUTION SIGNATURES FOR APPROVAL DATE BUSINESS OFFICE USE
PLEASE INDICATE CHECK DISTRIBUTION PREFERENCE BELOW Employee* APPROVED BY

DATE
Hold for Pick Up Supervisor* AC#
Return to Employee Additional Supervisor VH#
Mail to Address Attached Address to be mailed: ENTERED BY


PERIOD


Please complete this form in accordance with LETU Financial Services Policy 5.1.7, available at www.letu.edu/start/
Remember to attach all appropriate supporting documentation including support for mileage.
After appropriate approval, send the original to the Business Office and keep a copy for your records.

Enter an email address if you would like this form to be sent to an email

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