| 1 |
DATE |
Date requisition is completed |
Current date |
| 2 |
NAME |
Traveler's name |
Traveler's name |
| 3 |
SSAN |
Social Security Account No. |
9 digit SSAN. IRS requirement |
| 4 |
TELEPHONE No. |
Traveler's telephone number |
Campus extension |
| 5 |
POV LICENSE No. |
Private Owned Vehicle license plate number. |
Alphanumeric license plate no. IRS requirement |
| 6 | APPROVING OFFICIALS SIGNATURE |
Signature of Traveler's superior |
N/A |
| 7 | PURPOSE OF TRAVEL |
State justification for travel |
Conference, seminar, field work, etc. |
| 8 |
DESTINATION |
Location of University business |
City, State/Province, Country, as applicable. |
| 9 |
DEPARTURE DATE |
Date traveler left campus |
2 digit month/day/year |
| 10 |
DEPARTURE TIME |
Time traveler left campus |
hh:mm specify a.m/p.m. |
| 11A |
CHARGE TO FUNDS |
Allows you to split expense b/t 3 funds to charge the travel |
Standard fund names used for purchasing, IC for initial complement, etc. |
| 11B |
AMOUNT OR % OF TOTAL |
Allows you to specify dollar amount or percentage of travel expense to charge to each fund. |
e.g. $100.00 to IC remainder to NSF, or 60% NSF/40% IC, etc |
| 11C |
SEPARATE FUNDS/ ADVANCES |
Used if a travel advance or PO |
Annotate check or PO number |
| 11D |
AMOUNT OR % OF TOTAL |
Allows you to specify dollar amount or percentage of travel advance or PO each fund. |
e.g. $100.00 advance, etc. |
| 12 |
RETURN DATE |
Date traveler returns to campus |
2 digit month/day/year |
| 13 |
RETURN TIME |
Time traveler returns to campus |
hh:mm specify a.m/p.m. |
| 14 |
EXPENSE ESTIMATE |
Title Block |
N/A |
| TRANSPORTATION |
Title Block |
N/A |
| 15A |
SURFACE |
Allows you to select type of surface conveyance for your travel |
Select "POV" check
box for personal vehicle; "Rental Vehicle" check box for rented car;
select "Other" check box for mass transit, rail, shuttle, ferry,
parking, tolls, etc. |
| |
In-state |
For travel w/I California |
Check button if applicable |
| |
CONUS |
For travel w/I USA |
Check button if applicable |
| |
International |
For travel outside USA |
Check button if applicable |
| |
AMOUNT |
Annotate expense for each selection |
List in U.S. currency |
| 15B |
AIR |
Select when traveling via air |
N/A |
| |
In-state |
For travel w/I California |
Check button if applicable |
| |
CONUS |
For travel w/I USA |
Check button if applicable |
| |
International |
For travel outside USA |
Check button if applicable |
| |
AMOUNT |
Annotate expense for each selection |
List in U.S. currency |
| 16-20 |
LODGING/MEALS/ BUSINESS EXPENSE/ CONF./EVENT FEES/ REMOVAL EXPENSE |
Annotate expense for each selection as applicable. |
List in U.S. currency |
| 21 |
TOTAL COST |
Sum of 15A through 20 less any advancements (Block 11A-D) |
List in U.S. currency |
| 22-23 |
FAU DATA/MSO REVIEW |
EE Accounting Asst./Dept. Mgr entries |
N/A |
| 24 |
REMARKS |
Additional information you may want to provide to expedite your reimbursement |
Optional |
| 25 |
SUBSISTENCE SYNOPSIS |
A brief overview to aid you in completing your requisition. Explains the M&IE rates for various travel situations. |
N/A |