Mileage reimbursement may be denied if information is incomplete, travel was not approved in advance, or the legitimacy of the reimbursement claim is in question.
Employee name: __________________________________ Date: __________________
Department: ______________________________________________________________
Date of travel | Location traveled from | Location traveled to | Miles traveled (minus the mileage for your home to work commute) | Reason for travel (i.e. conference, seminar) |
Total miles traveled: ________________________________
Employee signature: ________________________________ Date: _______________
Supervisor's signature: ______________________________ Date: _______________
Return all signed and completed forms to the accounting department.
Accounting approval signature: ________________________ Date: ________________
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