UT Math Traveler's Reimbursement Worksheet

(RECEIPTS ARE REQUIRED EXCEPT WHERE SEPECIFIED)

Please email your receipt to Adriana Tolentino.

Today's Date: 09/20/2024

Name:   E-mail:   EID:
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.

Check Distribution Method

Direct Deposit
By Mail

If by mail, please provide your mailing address.



Destination(s)
    Destination #1:      Dates:
    Destination #2:   Dates:
    Destination #3:   Dates:

  Departed Austin Date:    Time:     AM   PM
  Returned Austin Date:  Time:   AM   PM

Transportation (receipt are required)
Airfare   $   Direct Paid     Yes   No  (Paid directly throgh these approved agencies:
   http://www.utexas.edu/services/travel/contact.html)
Rental car  (receipts are required)  $   Fill-up of rental return   $
See website http://www.utexas.edu/services/travel/rentalcar.html for UT discount agencies, phone #'s rates etc.)

Ground Transportation (receipts are required, taxi to/from Austin Airport without receipt $35.00 )
Method:  From:  To:  Date:  Amt: $
Method:  From:  To:  Date  Amt: $
Method:  From:  To:  Date:  Amt: $
Method:  From:  To:  Date:  Amt: $

Personal Auto?      Yes    No        From      To  
Reimbursement rate is 54 cents per mile based on actual distance provided by the Office of Accounting. Reimbursement is limited to the lower of (A) average coach airfare, plus other allowable transportation expenses that would have been incurred or (B) allowable mileage at the current reimbursement rate plus any applicable meals and lodging allowance. Reimbursement of fill-ups is not allowed.
Parking  (recipts are required)  $

Lodging        Number of days   Amount  $
Meals        Number of days
(lodging receipts are required)
NOTE: Meals are not reimbursable if there was no overnight stay for Texas travel. Meal reimbursement Per Diem: $51 per day. A written explanation is needed to justify the need for exceeding $51.

MISCELLANEOUS EXPENSES

Registration Fees: (receipts is required) $
Please state the name and the organization and what the fee was for

Other

NON-REIMBURSABLE EXPENSES include tips or gratuities, excess baggage charges for personal belongings other personal expenses such as the rental of video tapes for personal entertainment, alcoholic beverages, non-business phone calls, dry cleaning and laundry.



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