PERSONNEL BMDA03.125 AP.22

Travel Voucher- Out of District

Employee ______

Home Address ______Conference Leave Request Number ______

______Building ______

______Funding Source ______

Mo. / Day / Time of / Location / Private Auto Mileage / Tolls*/
Parking / Lodging / Meals / Totals
Departure / Return
From To / B
L
Purpose: / D
Mo. / Day / Time of / Location / Private Auto Mileage / Tolls*/
Parking / Lodging / Meals / Totals
Departure / Return
From To / B
L
Purpose: / D
Mo. / Day / Time of / Location / Private Auto Mileage / Tolls*/
Parking / Lodging / Meals / Totals
Departure / Return
From To / B
L
Purpose: / D
Mo. / Day / Time of / Location / Private Auto Mileage / Tolls*/
Parking / Lodging / Meals / Totals
Departure / Return
From To / / B
L
Purpose: / D
Totals for this page
Enter Mileage From all Pages ______(Miles) x ___ cents per mile
/ TOTALS FROM
CONTINUATION PAGES
GRAND TOTAL

*Tolls (none for District vehicles being operated in state in an official capacity)

______

Employee’s Signature Date Supervisor’s Signature Date

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PERSONNEL BMDA03.125 AP.22

(Continued)

Travel Voucher- Out of District

FIELD / DESCRIPTION
Check Number / Not applicable/Disregard.
Vendor Number
Invoice Number
Amount Paid
Code Number
Approved for Payment
Conference Leave Request Number / Write in number assigned to your leave request.
Building / Write in building you are assigned to.
Funding Source / Write in the program that is paying the bill.
Month/Day / Enter the month and the day on which travel occurred. Make a separate entry for each day.
Time of Departure/Return / Enter the time of departure and return, specifying AM or PM.
Location / Enter the cities of origin (from) and destination (to).
Private Auto Mileage / Enter the miles drive on this date in the employee’s vehicle.
Other Attach / Enter the amount of other expenses and attach the receipt.
Lodging / Enter the cost of lodging for the day including tax, excluding extra room.
Meal Allowance / Enter the total amount due per meal on this date, if applicable. For a meal allowance to be granted, you must be on an overnight trip and: to get breakfast, you must leave before 6:30 AM or return after 9:00 AM; to get lunch, you must leave before 11:00 AM or return after 2:00 PM; to get supper, you must leave by 5:00 PM or return after 9:00 PM. If a conference fee includes a meal, do not claim the allowance for that meal. If you are on an out-of-state trip, you may charge what the IRS allows for the city you are in. This publication is in your building. For such a trip, concerning the day of departure, return or a day a meal is provided, you are to prorate the daily rates for that city. Simply, multiply the daily rate by 20% for breakfast, 30% for lunch and 50% for supper.
Purpose / Write in the purpose of the trip.
Totals / Enter the sum of other, lodging and meals for this date.
Totals for this page “Other” column / Enter the sum of all other expenses for this page in the “other” column.
Totals for this page “Lodging” column / Enter the sum of all the lodging expenses for this page in the lodging column.
Totals for this page “Meals” column / Enter the sum of all meal allowances for this page in the meal column.
Totals for this page “Totals” column / Enter the sum of all of the daily expenses listed in this column.
Enter Mileage Expense / Calculate and enter the total mileage expense (miles x allowance per mile).
Totals From All continuation Pages / Enter the total expenses from all of the continuation pages, if applicable.
Grand Total / Enter the total of “Totals for this page, “Totals” column. Total of the mileage, total of all continuation pages. This should be the amount of the check the employee should receive if filled out correctly.
Employee’s Signature & Date / Sign and date.
Supervisor’s Signature and Date / Supervisor signs and dates.

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