PDF Invoice for Reimbursement for Travel Expenses For: Columbus ...

INVOICE FOR REIMBURSEMENT FOR TRAVEL EXPENSES FOR: COLUMBUS PUBLIC SCHOOLS

Pay To: Address:

Expenses Incurred From: Expenses Incurred To: For:

Location Location

Date: Date:

Purpose and Destination of Trip

MEALS DATE BREAKFAST LUNCH DINNER TOTAL

DATE

LODGING PLACE AMOUNT

Total

TRAVEL BY PRIVATE AUTOMOBILE (54 cents per mile)

Personal Vehicle Beginning Point:

TRAVEL BY PUBLIC CARRIER (Bill to be Attached)

Name of

Carrier

From

Total Pre-Paid

miles @ .54 = $ Ending Point

To

Date

Total Amt.

TO BE COMPLETED BY PRINCIPAL: (Charge to the following fund)

TOTALS:

Meals

$

Lodging

$

Transportation

$

Other (Parking)

$

TOTAL INVOICE

$

Employee Signature: __________________

Approved: __________________ Principal / Supervisor

Approved for Payment: ____________________________________________

REVISED 01/05/2015

All travel must be submitted within ninety (90) days for reimbursement eligibility

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