Information needed for an Out-of-State Travel Request and Voucher to be processed.

TRIP INFORMATION:
(Office use only) Trip Number: Number is automatically assigned by the OSU system.
Name:
Account Number: / If NOT a PaSS account indicate which department:
CWID: / Your E-mail Address:
Request/Estimate / Voucher/Final Cost
Date
00-00-0000 / Time / AM or PM / Date
00-00-0000 / Time / AM or PM
Trip Start Date and Time:
(Date and time you plan/actually left Stillwater.)
Trip End Date and Time:
(Date and time you plan/actually returned to Stillwater.)
Nature of Official Business:
Request/Estimate / Voucher/Final Cost
Date
00-00-0000 / Time / AM /PM / Date
00-00-0000 / Time / AM/ PM
Meeting Start Date and Time:
(First act of business – not necessarily your presentation)
Meeting End Date and Time:
(Last act of business – not necessarily your presentation)
Destination (City and State):
Use the Space below for Multiple Destination Trips(e.g. Dallas to Kansas City[Attach additional information as needed.]):
Second Destination: Nature of Official Business:
Request/Estimated Times / Voucher/ActualTimes
Date
00-00-0000 / Time / AM/PM / Date
00-00-0000 / Time / AM/PM
Meeting Start Date and Time:
(First act of business – not necessarily your presentation)
Meeting End Date and Time:
(Last act of business – not necessarily your presentation)
Destination (City and State):
TRANSPORTATION:
Transportation/Mileage: Must have estimates/receipts for parking, toll road, taxi/shuttle(taxi/shuttle-reimbursement only for airport/hotel/airport expense – not for eating out or site seeing).
Mode of Transportation to Airport:
Yes or No / Tag# Required / Yes or No / Tag# Required / Yes or No
OSU Vehicle / PersonalVehicle / Rode with Someone
Request/Estimated Cost / Voucher/ActualCost / How did you pay for this?
Cash / Personal Credit Card / OSU P-Card
Personal Vehicle Mileage:
Parking Fees:
Taxi:
Shuttle:
Rental Car:
Airline Ticket: (If you purchase your ticket yourself from a non-state contracted travel agency you will need to provide the price of your ticket and a hard copy quote from Concur Solutions.)
Yes/No / Yes/No / Yes/No
Purchase Ticket Myself / OSU will purchase my ticket (Direct Bill) / Purchase Ticket with P-Card
Someone else will purchase my ticket (please explain):
Request/Estimate / Voucher/ActualCost
Airline Ticket Price:
Airline Baggage Fees:
Use this for Airline Quote if you purchased ticket yourself (quote must be from Concur Solutions) amount:
Out-of-State Mileage Requirements:(If one personal vehicle is used to travel out-of-state or multiple travelers, the mileage will be limited to the total cost of mileage or whichever is the cheapest amount of an airfare quote obtained from Concur Solutions times the number of travelers in the vehicle plus mileage to/from the airport. The travelers must be on University business and not family/friends.)
Request/Estimate / Voucher/ActualCost
Out of State Personal Vehicle Mileage:
LODGING
Lodging/PerDiem: Attach documentation from conference showing designated hotel and conference room rate, when no designated hotel use the GSA website rates plus taxes (
How was your lodging paid for?
Yes/No / Yes/No / Yes/No
P-Card (Faculty Only (Unless you have written permission from faculty))
/ Personal Credit Card/Check/Cash / Direct Bill
Lodging was paid by someone else: (Please Explain)
Request/Estimate / Voucher/ActualCost
Lodging Amount: (You must have a hotel receipt with your name on it and a zero balance. Even if paid with P-Card)
Internet charge from hotel:
Per Diem (Meals): You can keep your receipts and use that amount for reimbursement or you can use the state per diem rate. Please indicate which you choose to use.
Yes/No / Yes/No
I prefer to turn in receipts / Use State per diem
REGISTRATION
Registration: Must have a meeting registration receipt with your name on it. (even if paid with P-Card)
Yes/No / Yes/No
Registration Amount: / Registration paid by OSU P-Card / Registration paid by Personal Credit Card/Check/Cash
Registration was paid by someone else: (Please Explain)
Yes/No / How Many?
Were Meals included in the Registration Amount? / If yes how many meals were included?
MISCELLANEOUS EXPENSES
ADDITIONAL ITEMS REQUIRED TO AQCCOMPANY YOUR TRAVEL CLAIM
Meeting Agenda must be attached, which should include the name of the meeting, date, time, location (city and state), and the registration fee. The first thing you did, your presentation and the last thing you did.
Designated Lodging Rate documentation showing designated hotel and lodging rate must be attached if applicable.
Airfare Quotes must be attached if required.
Receipts attach all required receipts.