IC Travel Services: Expense Report Form

Expense Report Form

All travel must be in compliance with the College's Travel Policy.

This form is used to capture a trip's total expenses for all travelers.

Complete this form within ten business days upon return from travel. Reimbursements will be based on one final approved Expense Report Form.

All payment methods MUST be listed on this form including Cash Advances.
All original receipts requiring reimbursement should be taped to 8 ½" x 11" sheets of paper. When original receipts are not available, prepare, sign and attach a memo explaining the expense.
When requesting reimbursement, Departmental Coordinators must forward Expense Report Forms including documentation to Travel Services.
Attach copies of all Travel Card receipts (originals should remain with the credit card statement at the departmental level).
Attach copies of all pre-trip expense documentation (i.e. VAF, PO).
For International Travel, additional instructions can be found in the International Travel section of the Travel Policy.
Contact Tami Hastings at (607) 274-1480 with questions.

* 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 Ground (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 expenses including those paid with Cash Advance monies	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 IC reimburses up to 180 miles per trip $.565 per mile x miles
Parking/tolls
Ground transportation - incl. gratuity for bus, taxis, shuttle
Lodging - incl. gratuity
Meals - incl. gratuity
Other:
Other:
Other:
SUBTOTALS:
Maximum funding authorized (If no maximum, leave blank)			$
Total expenses paid by traveler			$
Total Cash Advance(s) (include cash advance amount from Travel Card if applicable)			$
Amount due to College from traveler Payable to Ithaca College - deposit at Cashiering Services Include deposit receipt with expense report			$
Amount due to traveler			$
REIMBURSEMENT FUNDING SOURCES AND AMOUNTS
Reimbursement amount due to the traveler - enter account(s) to be charged below
Account 1 *		* Amount 1	$
Account 2		Amount 2	$
Account 3		Amount 3	$
		REIMBURSEMENT TOTAL:
* I acknowledge that in order to comply with IRS regulations, I will reconcile my College travel expenses on an Expense Report Form within 60 days upon return from travel. In the event that an Expense Report Form is not submitted to Travel Services within the 60 day time frame, any college paid expenses will be treated as my personal income. These funds will be subject to required payroll tax withholding and reported on my W-2 Form. College related travel expenses incurred using personal funds will be ineligible for reimbursement after 60 days.