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Department of History
Reimbursement Request Form
Reimbursement Request Form
Reimbursement requests for expenses older than sixty (60) calendar days will be taxable to the traveler. Reimbursement requests for expenses older than one hundred twenty (120) days will be denied, see University Policy 6290 (Accountable Plan).
Name:
(Required)
First
Last
Employee ID:
(Required)
Email
(Required)
Reason for reimbursement
(Required)
Travel
Non-travel
TA Number (5-digits)
Travel Location:
(Required)
City, State/Country
Select expenses for which you are requesting reimbursement.
(Required)
Provide exact dollar amounts for each expense selected. You will be prompted to upload itemized receipts for reimbursable expenses. (See below.)
Airfare
Lodging
Registration
Transportation-Personal Vehicle
Transportation-Public
Transportation-Rental Car
Miscellaneous
Per Diem
Airfare
(Required)
Lodging
(Required)
Registration/Membership
(Required)
Per Diem
(Required)
*Business meals will not be reimbursed if they have been paid for by other means such as per diem or meals included in prepaid conference fees.
Transportation-Personal Car - Mileage Log: https://www.boisestate.edu/vpfa-travel/tools-resources/
(Required)
Transportation-Public
(Required)
Transportation-Rental Car
(Required)
Miscellaneous
(Required)
Non-travel related expense
(Required)
Total Reimbursement Requesting
Please add additional information if necessary.
(Optional)
Receipts.
You have the option to upload all receipts as one file or each receipt individually. These are not required fields as each submission will be different.
All receipts as one upload.
Max. file size: 10 MB.
Receipt #1
Max. file size: 10 MB.
Receipt #2
Max. file size: 10 MB.
Receipt #3
Max. file size: 10 MB.
Receipt #4
Max. file size: 10 MB.
Receipt #5
Max. file size: 10 MB.
Receipt #6
Max. file size: 10 MB.
Receipt #7
Max. file size: 10 MB.
The following information is necessary for the administrator to calculate per diem.
Travel Departure Date:
(Required)
MM slash DD slash YYYY
Time of Departure
(Required)
Hours
:
Minutes
AM/PM
AM
PM
AM/PM
AM/PM
Travel Return Date:
(Required)
MM slash DD slash YYYY
Time of Return
(Required)
Hours
:
Minutes
AM/PM
AM
PM
AM/PM
AM/PM