South Dakota Counseling Association
Travel and Expense Voucher
(Revised June 2016)
Name: ______Date: ______
Purpose of Travel: ______
Departing From: ______Time Departed: ______
Traveling To: ______Time Returned: ______
Travel to conduct business for the South Dakota Counseling Association shall be reimbursed. It is common philosophy that the most austere method of travel and lodging be adhered to. When the expenses of members are being paid for by association funds, it is expected that individuals will attend all portions of meetings/trainings for which they are being sponsored.
Private auto travel will be reimbursed using the chart on the bottom of this sheet. Per diem will be given for meals. In-state meals at $5.00 breakfast; $7.50 lunch; $10.00 dinner. Out-of-state meals at $10.00 breakfast; $12.50 lunch; $20.00 dinner, providing the total amount does not exceed the amount budgeted for such travel. Questions on reimbursement will be resolved by the SDCA Executive Committee. Hotel and commercial carrier receipts must be attached. One must depart before 7 AM to claim breakfast, before 11 AM for lunch, 5 PM for dinner, and not return home before 1 PM for lunch and 7 PM for dinner. Do not claim meals that are covered by registration fees.
DATE: ___/___/___ Breakfast: _____ Lunch: _____ Dinner: _____ TOTAL: $ ______
DATE: ___/___/___ Breakfast: _____ Lunch: _____ Dinner: _____ TOTAL: $ ______
DATE: ___/___/___ Breakfast: _____ Lunch: _____ Dinner: _____ TOTAL: $ ______
DATE: ___/___/___ Breakfast: _____ Lunch: _____ Dinner: _____ TOTAL: $ ______
Total miles by private auto ______miles with _____ passengers @ $ ._____ $ ______
Commercial carrier (attach receipt)……………………………………………….. $ ______
Hotel (attach receipt)……………………………………………………………….. $ ______
Meals (from above)…………………………………………………………………. $ ______
Registration (attach receipt)……………………………………………………….. $ ______
Other (attach receipts)……………………………………………………………… $ ______
TOTAL REIMBURSEMENT DUE…………………………………………………. $ ______
I declare and affirm under the penalties of perjury this claim has been examined by me, and to the best of my knowledge and belief is in all things true and correct.
______
Signature of Claimant Date
Approval and Authorization:
______
Check Number Seth Olson, Treasurer Date
TRAVEL REIMBURSEMENT CHART Fill Out and send to
(effective November 2015) Seth Olson-SDCA Treasurer
1-2 persons - .35 904 W Tradewinds St
3-5 persons - .40 Sioux Falls SD 57108
(NOTE: The above was enacted to encourage carpooling of members.)
**** Please fill out a CHECK REQUEST FORM and submit it with your Travel Voucher.