Reimbursement Claim Form

NSTC

Reimbursement Claim Form

Name ______
Mailing Address ______
City, Zip code ______
Email ______/ Submit Claim to: NSTC Treasurer
Molly Sinnott
P.O. Box 3294
Carson City, NV 89702

______Claimant Signature Date

Complete the following for public transportation (air, ground), parking, incidental, meals, and hotel. Rental vehicles require preapproval. Per diem follows allowable GSA rates. Receipts required for reimbursement of expenses.

Date / Flight / Airport
Parking / Total
B / L / D / Hotel
$ / $ / $ / $ / $
$ / $ / $ / $ / $ / $
Total Per Diem Claim: $

Complete the following if requesting reimbursement for personal vehicle mileage.

Date / Purpose of Each Trip
/ Start Mileage / End Mileage / Total Mileage / @ Rate / Reimbursement
Total for Travel Claim
Complete the following if requesting reimbursement for supplies. Receipts required.
Date / Vendor name and title/description of project. Attach detailed receipt/invoice / Total
$
Total for Operating Claim / $

Shaded area for NSTC Treasurer/Secretary use only.

Attendee eligible for per diem reimbursement?

Approved by: / Date / Check # / Amount $
CATEGORY
TOTAL / Overhead / Indirect $ / Contractual $ / Operating $ / Travel $

NSTC Expense Reimbursement Policy

NSTC will reimburse eligible members, presenters and designated trainees (eligible attendees) for actual meal costs up to the State of Nevada rates (State Administrative Manual 0232.0), as well as lodging which is reimbursed at actual cost up to the approved state (GSA) rate. Receipts showing proof of payment must be submitted for all expenses before reimbursement will be made. Attach all receipts to the NSTC Reimbursement Claim form (reverse side of this sheet) for any reimbursement request.

Eligibility for per diem reimbursement

Eligible attendees not on agency per diem are eligible for per diem reimbursement if the following condition is met: attendee is an NSTC member, meeting speaker/trainer, or designated trainee. Not eligible are exofficio, honorary members, federally funded staff on work time or guests. For group meals, NSTC will request the reimbursement for the meal per diem for all eligible attendees. Attendees being paid per diem by their employer are not eligible for meals taken at NSTC’s expense.

Maximum reimbursable rates: NSTC follows federal GSA travel rates found at:

GSA - Domestic Per Diem Rates http://www.gsa.gov/portal/category/21287

Click on the state of Nevada; find the location (town/county) and appropriate time period to find maximum lodging rate. Rate for meals and incidental is shown in the far right column-M&IE. Follow the link provided below to find the M&IE rate breakdown for the maximum allowable costs for breakfast, lunch, dinner and incidental. To be eligible for per diem, eligible attendees are eligible for meals when the following conditions are met: Breakfast: leave before 7:00 a.m.; Lunch: leave before 11 and return after 1:00; Dinner: leave before 5:00 p.m. and return after 6:00 p.m.

Transportation
Use of the most economical transportation, for example ride sharing, is encouraged to minimize cost to NSTC.

Air travel. Actual costs will be reimbursed based on the receipt for the plane ticket for the lowest available rate posted one month prior to the meeting. Early check-in fees (eg. SWA Earlybird) are not reimbursable.

Parking. Reimbursement based on receipts.

Rental Cars. A rental car should only be requested if no other transportation is available. Local NSTC members usually arrange airport pickup. Vehicle rental requires advance approval from NSTC’s Executive Board.

Ground Transportation. Reimbursement is based on receipts.

Other travel related expenses
Mileage reimbursement. Check GSA site for current rates.

Other expenses
Include payment for meeting rooms, office supplies, educational materials, display materials, outreach and other eligible costs. Actual costs will be reimbursed with receipt.

Special circumstances
If you have expenses that do not meet the above categories or are unsure of the reimbursement policy, prior approval is required from the NSTC before you become liable for the expense.

Revised 01/01/16