Form – Research and Creative Activity Expense Report Request

Please use this form to submit all receipts for travel-related reimbursement.

RCA Travel Reimbursement Request

Name(Required)

First Last

Email(Required)

Which department is the funding for this coming from?(Required)

Please provide the fund source for this reimbursement(Required)

(e.g. 4010.70610.1001004.2000001010)

Please provide the Travel Authorization number for your trip(Required)

Are you requesting reimbursement for Per Diem?

Yes

How would you like to be reimbursed for Per Diem?

I will provide receipts for meals

Please reimburse me at the Per Diem Rate

In order to be reimbursed for per diem, you must upload an itinerary (including conference agenda, or detailed schedule of pertinent activities, and flight schedule, if applicable). Please note below any meals provided by the conference.

Per Diem – Provided Meals

If meals were provided during your travel please indicate which meals and the days which they were provided below.

The following information is required to determine Per Diem reimbursement allowability. If you are attaching a flight itinerary/receipt you do not have to complete this section.

Travel Departure Date

What day did you depart for travel?

Departure Time

What time did you depart for travel?

AM/PM

Travel Return Date

What day did you return for travel?

Return Time

What time did you return from travel?

AM/PM

Comments/Notes

Is there anything you would like us to know about this request?

All receipts must be submitted at once for reimbursement. Attach one or more of the following: (1) conference agenda or detailed schedule of pertinent activities, (2) flight receipts (and flight itinerary if per diem requested), (3) lodging receipts, (4) ground transportation receipts and (5) mileage — include a mileage log and Google Map (or similar) directions showing miles.

If personal travel is included in your itinerary, attach several comparable flight (or other transit) quotes for the days you would have traveled if personal travel was excluded.

Upload Necessary Documentation(Required)

All receipts must be submitted at once for reimbursement.

Drop files here or

Accepted file types: pdf, xls, xlsx, doc, docx, Max. file size: 10 MB.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Form – Research and Creative Activity Expense Report Request

RCA Travel Reimbursement Request

College of Arts and Sciences