Travel Reimbursement Request

Please complete the form below and submit electronically. Also remember to provide paper copies of all appropriate receipts and return it to this office WITHIN 5 DAYS AFTER TRAVEL so that your travel reimbursement voucher may be prepared. You may be reimbursed single occupancy hotel rate plus tax if applicable, $.445 per mile or airfare round trip coach, limo, parking and allowable meals at the rate of $6.00 breakfast, $11.00 lunch, and $19.00 dinner dependent upon times of travel or GSA rates based on city or per diem rate of $80.00 per day. Meals provided by the program will not be reimbursed. YOU MUST SUBMIT ORIGINAL RECEIPTS FOR PARKING, TAXI OR LIMO AND YOUR HOTEL BILL SHOWING A ZERO BALANCE FOR SINGLE OCCUPANCY RATE. Otherwise reimbursement will be delayed or limited.

Date
MM slash DD slash YYYY
To:
From
Email
UF ID No.*
Date of Departure (from your city)*
MM slash DD slash YYYY
Time*

: Hours

Minutes

AM/PM
Date of Return (to your city)*
MM slash DD slash YYYY
Time*

: Hours

Minutes

AM/PM
Tolls:

Please enter total cost of Tolls paid.
Parking:

Please enter total cost of parking paid.
Taxi or Limo:

Please enter total cost of taxi or limo services paid.
Airfare:

Please enter total cost of airfare.
Hotel

Please enter total cost of hotel.
Registration

Please enter total cost of registration and be sure to provide a hard copy of your original receipt as well as conference schedule (if applicable).
Round trip mileage: Quantity
Price: $0.44
Total
$0.00