Kentucky Department of Agriculture

REQUEST FOR AUTHORIZATION OF OUT-OF-STATE AND OUT-OF-COUNTRY TRAVEL

This request must be submitted to the Commissioners Office no later than 30 days prior to the departure date. Department: Agriculture Office and Division: Date

This Office/Department has funds available and requests advance authorization for the following out-of-state or outof-country travel to be charged to this agency account(s):
FUND FUNCTION (PBU) OBJECT MAJOR PROGRAM (PROJECT #) TOTAL

TOTAL AMOUNT OF TRIP NOT TO EXCEED:

NAME OF EMPLOYEE

POSITION

EMPLOYEE eMARS ID

eMARS Authorization No.

TE TE TE TE

035 035 035 035

List the name of each employee in the Name of Employee column and list their estimated individual expenses.
Expense Breakdown LODGING PERDIEM AIRFARE MILEAGE REGISTRATION FEE MISC (PARKING, TIPS, ETC.) TOTAL NAME OF EMPLOYEE NAME OF EMPLOYEE NAME OF EMPLOYEE NAME OF EMPLOYEE

From (Origin) Date(s) trip to be taken (include travel time)

To (Destination)

Attach Justification for trip on separate sheet. Cite benefit to the Department. Do not abbreviate organization names. If more than four employees of your agency are going to this event, explain how many and why.
Will a State check be issued for registration fee? Car Rental Justification Method of Conveyance: State Vehicle Other YES NO Airplane Car Rental Commercial YES N0 Charter

Personal Auto Explain Other

I hereby certify that it is necessary for the people or officers named above to make this trip on official business connected with the duties of their positions.

Director Employee

Date Date

Executive Director

Date