IC Travel Services: Travel Authorization Form

Travel Authorization Form

This form is used by the College to track the total cost of a trip, approved travelers, and ensure adequate funding prior to a traveler's departure
Complete this form at least 8 weeks prior to international trips and 2 weeks prior to domestic trips
Give the completed, authorized form to your departmental business coordinator. If the trip is international, also send a copy to Travel Services for their records
All travel must be in compliance with the College's travel policy, found on the Travel Services website
Expense reports must be submitted 10 business days after returning from a trip.
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
* 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	For international travel, also submit a signed copy of this form to Travel Services
Trip purpose *
Number and type of travelers*
Full names of additional travelers* Enter N/A if you will travel alone
FUNDING SOURCES AND AMOUNTS
Trip does not require College funds	Check this box to indicate this trip will not use IC funding.
Maximum funding authorized	$
Internal account number(s) for funding/grant & amounts*	Example: 01.06.50.999.7413.000.00000 -- $2,000; 03.02.50.999.7413.000.29000 -- $1,000
External funding sources & amounts	Example: ROTC -- $500
ANTICIPATED EXPENSES Itemized receipts required for all expenses
Registration	$
Airfare	$
Lodging	Nights at $ each =
Meals	Days at $ per day =
College vehicle Sedan/Prius --$38 per day Minivan -------$45 per day	$	You will see the Vehicle Request Form link after you submit this form
Personal vehicle - estimated mileage (#miles @ $.55)	$ Personal vehicle insurance applies. Ithaca College reimburses up to 180 miles per trip.
Ground Transportation (bus, taxi, shuttle, train, etc)	$ Enterprise Rent-A-Car & reservation instructions
Other Costs (describe)	$
	$
TOTAL ANTICIPATED TRAVEL EXPENSES REQUESTED

ADVANCE FUNDS REQUESTED		Limited to international and student group travel Contact Travel Services for more information
Cash travel advance amount requested	$
Traveler's checks amount requested	$
Total advances

* 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.

this page maintained by Mariko Evans:: last updated on October 30, 2009