UT Math Travel Authorization Form

Notes to traveler: Use contracted UT travel agency request for state contact rate. Original receipts are required except meals. If meal expenses exceed $51 per day, receipts are required with a written explanation to justify the need for exceeding $51.00. All airfare tickets will be issued "ticketless" unless otherwise requested.

Today's Date: 10/02/2023

Name:   Title:
EID:   E-mail:
Disclosure of your Social Security Number ("SSN") is required of you in order for The University of Texas at Austin to process your reimbursement, as mandated by State and Federal law. Further disclosure of your SSN is governed by the Public Information Act (Chapter 552 of the Texas Government Code) and other applicable law.

Travel Dates (MM/DD/YYYY)
Departure Date:    Return Date: 

Will there be any cost to the University?  Yes    No
If yes, provide an estimated cost and number of days (lodging and meals)
Estimated number of days    Estimated cost

Is travel request for a Faculty Travel Grant?      Yes    No
Airfare Direct Paid?      Yes    No

Estimated Expenses
Transportation:  Lodging:  Meals:  Registration:  Other: 

Rental Car:    Avis   Budget  Enterprise  National  Hertz  No Rental Car

Source of Funds:     NSF   TARP   Other

Destination(s) name city & state & town & country
    Destination #1:   From: To:
    Destination #2:   From: To:
    Destination #3:   From: To:

For Washington DC Travel Only
  Federal Congressional Testimony   Federal Congressional Visit   Agency Visit (General)
  Agency Visit (Grant Follow-ups)   Public Interest Grp or Prof Assoc Mtg   Organization
Person(s) visited:

Purpose of Travel other than DC (select one or more)
  Attending Mtg. Conference etc.   Conduct lecture or teach a course   Perform research activities
  Participate or officiate in an event   Recruit prospective employee or student   Present original research paper

Specify in detail or give complete conference name and title of paper
Benefit to UT
  Help accomplish research objectives   Help fulfill contract provisions   Enhance performance job duties
  Enhance grad/undergrad curriculum   Enhance reputation of UT
Specify in detail

Deposition of duties while absent
  No classes missed   Duties assumed by colleagues   Duties held until return (specify)
Course(s)  Time(s)
Dates(s)  Taught by

Office Use
Acct #:  Transp.: 
Acct Title:  Lodging: 
Acct #:  Meals  
Account Title: Registration: 

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