IC Travel Services: Expense Report Form

The purpose of this form is to capture a trip's total cost; this form lists travelers and trip expenses. Expenses are then charged to College account number(s) and travelers will be reimbursed for approved out of pocket trip expenses.
Expense report forms must be submitted 10 business days upon return from travel to your business coordinator.
Pursuant to IRS guidelines, 60 days after a traveler's return out of pocket trip expenses are ineligible for reimbursement; travel card purchases will be considered taxable income
All travel must follow Ithaca College travel policies and procedures
All expenditures must be reasonable and have a legitimate business purpose
All expenditures listed must match submitted receipts and have adequate documentation
All original documentation for reimbursements to travelers, and copies of receipts charged on an Ithaca College Travel Card, should be taped to 8 ½" x 11" pieces of paper and submitted along with the printed expense report form.
- Itemized restaurant receipts (as opposed to stub-receipts) should include the date, name of the establishment and details of purchase.
- If money is owed to the College, deposit at Cashiering Services and include the deposit receipt with the expense report form
Cash advances MUST be listed on the expense report form.
If you have questions about this form, contact Tami Hastings at 607.274.1480
* Indicates required field

TRAVELER CONTACT INFORMATION
Name *
Department *
Email *
Home address *
Home/cell phone *
Campus address *
Campus phone *
TRIP INFORMATION
Date of departure *
Date of return *
Destination(s) * Include Country, City, State	Domestic International
Trip purpose *
Estimated mileage * what's this?	Air Miles Ground Miles (numbers only please)
Number and type of travelers*	Indicate the number of each Faculty Staff Student(s)
Full names of additional travelers* Enter N/A if you traveled alone
TRIP EXPENSES Itemized receipts are required for all expenses
	$ Paid by Traveler Out of pocket/IC cash advance money, incl. gratuities	$ Paid by Ithaca College IC Travel Card, POs, or VAFs	$ Total
Registration
Airfare
Rented vehicle
College vehicle
Gasoline not reimbursed for personal vehicle use
Personal vehicle mileage miles @ $.555/mile IC reimburses up to 180 miles per trip
Parking/tolls
Ground transportation incl. gratuity - bus, taxis, shuttle
Lodging incl. gratuity
Meals
Other:
Other:
Other:
Subtotals summary

Maximum funding authorized (If no maximum, leave blank)			$
Total expenditures paid by traveler
Enter total advance(s) from Cashiering Services or IC Travel Card			$
Amount due to IC from traveler, payable to Ithaca College Deposit at Cashiering Services and include deposit receipt with expense report
Amount due to traveler
REIMBURSEMENT FUNDING SOURCES AND AMOUNTS
Accounts to charge for reimbursements to the traveler totaling
Account 1 *		Amount charged	$ *
Account 2		Amount charged	$
Account 3		Amount charged	$
		Total
I acknowledge that in order to comply with Internal Revenue Service regulations, Ithaca College employees must reconcile College travel expenses on an Ithaca College Travel Expense Form within 60 days of the date of return from the trip. Failure to perform this reconciliation within the 60 day time period will result in any College funds disbursed for trip related expenses being treated as taxable wages paid to the employee and subject to Federal and State Income Tax, Social Security and Medicare withholdings. Any College related travel expenses incurred using personal funds will be ineligible for reimbursement after 60 days. Reimbursements will be made on the basis of approved expense reports only. *