Travel Voucher

TV

Name of Employee:

CC

Account No.

Amount

(1)

(6)

(7)

(8)

Department:

(2)

Check if a completed copy

Campus Phone:

Soc. Sec. No.

of the voucher is desired by fax.

(3)

(4)

Total Amount

(9)

Email Address:

Fax Number:

(5)

Subsistence Chart:

If travel includes overnight lodging and at least these hours:

KY & US

US

Submit original to Accounts Payable - Travel Section.  Tape receipts on 8 1/2 x 11 sheet of paper.  Receipts must be attached for all charges over $10.00 except meals and toll charges.  Attach meeting agenda if trip was to attend a conference/seminar.

(Low Rate)

High Rate

Instructions for completion of this form is available on our website.

6:30am - 9am

Breakfast

$7

$8

11am - 2pm

Lunch

$8

$9

5pm - 9 pm

Dinner

$15

$19

Do not claim meals included in registration fees.

Month

Day

Time of

Personal

Parking,

Lodging

Personal Meals

Total

Time of Departure

Return

Auto

Toll Charges

Subsistence - lodging required

Miles

(10)

(11)

(12)

(13)

(14)

(15)

(16)

B

(17)

From-To:

(21)

(22)

L

(18)

Purpose:

(23)

D

(19)

(20)

B

From-To

L

Purpose

D

B

From-To

L

-

Purpose

D

B

From-To:

L

-

Purpose:

D

B

From-To:

L

-

Purpose:

D

Totals for this page:

(24)

(25)

(26)

(27)

Total Mileage:

(28)

x     *per mile

=    Total Mileage expense:

(29)

*Please visit the Accounts

Payable website

for current

mileage rates

I hereby certify, subject to the provisions of KRS 523.100 (unsworn falsification to authorities), that the above are proper charges by a statutory employee of the Commonwealth in the discharge of official business and that all data furnished herewith are true and correct to the best of my knowledge.

Other Expenses Total:

(30)

Continuation pages (pg 2-pg 4) total:

(31)

Grand Total of expenses:

(32)

(34)

Travel Expense Reconciliation

Claimant's Signature

Date

Grand Total of expenses:

(30)

(35)

Total amount PREPAID by NKU

(33)

Dean, Director, or Department Head's Signature

Date

Total  amount of reimbursement

(9)

(36)

Audit/Approved by

Date

1)  Employee's name

2)  Employee's department

3)  Employee's extension #, or person responsible for picking up check from A/P

(Please attach a self addressed, stamped envelope is check is to be mailed)

4)  Employee's Social Security number

5)  Employee's email address

6)  Campus code (1F or NK)

7)  Department's 10-digit account number to be charged (split code if necessary)

8)  Amount to be charged to each account number

9)  Total expenses to be reimbursed to employee

10) Month of travel

11) Date of travel

12) Time of departure

13) Time of return

14) Personal auto miles to be reimbursed (Lesser of NKU or home to destination)

15) Parking and toll charges for the day

(Receipt not required for tolls or items under $10)

16) Total cost of lodging for the day

17) Cost of breakfast for the day

(Must be in travel status per subsistence chart; overnight stay required for meals)

18) Cost of lunch for the day

19) Cost of dinner for the day

20) Total meals, lodging, parking, & toll charges

21) Initial departure point (NKU or home)

22) Final destination point

23) Business purpose of travel (Organization names must be spelled out completely)

24) Total parking & toll charges for page

25) Total lodging for page

26) Total meals for page

27) Total parking, tolls, lodging and meals expense for page

28) Total miles for page

29) Total mileage expense (Please visit the Accounts Payable website for current mileage rates)

30) "Other" expenses page total (Line 41 + Line 33)

31) Total from attached continuation pages

32) Grand total of expenses

33) Total amount prepaid by NKU (items prepaid by department - airfare, registration fees)

34) Employee's signature

35) Dean, Director, or Dep