READ ME FIRST

PLEASE READ THE INSTRUCTIONS, FOUND BELOW, BEFORE PROCEEDING TO THE FORM. TO CONTINUE TO THE FORM, CLICK THE TAB (BELOW) LABELED "TRAVEL FORM" OR USE CTRL + PAGE DOWN ON YOUR KEYBOARD

THINGS TO REMEMBER AS YOU USE THIS FORM: 1) TO INITIATE CALCULATION, AN ENTRY MUST BE MADE IN THE "DAY" COLUMN. 2) WHEN ENTERING TIME OF DEPARTURE/RETURN, USE THE FORMAT HH:MM MILITARY TIME OR HH:MM PM. FOR EXAMPLE, 6:30 PM SHOULD BE ENTERED AS 18:30 (MILITARY TIME) OR 06:30 PM. 3) ACCOUNTS PAYABLE REQUIRES THE (1) ORIGINAL TO BE SIGNED AND FORWARDED TO THEM. IF THE PAYMENT IS TO BE SENT TO AN ADDRESS THAT IS NOT IN DAFIS, THEN SEND AN ADDITIONAL (1) COPY, WITH THE CORRECT MAILING ADDRESS, TO BE USED IN THE ENVELOPE WINDOW. GIVE 1 COPY TO THE TRAVELER, AND KEEP 1 COPY FOR DEPARTMENTAL RECORDS. 4) THE "COST OF TRANSPORTATION" AMOUNT WILL BE AUTOMATICALLY CALCULATED WHEN MILEAGE IS ENTERED IN THE "PRIVATE CAR MILEAGE" COLUMN. * is calculated at: IN "COST mile Mileage THE FORMULA $0.445 perOF TRANSPORTATION" WILL BE REPLACED WHEN A STRAIGHT COST (e.g. AIRFARE) IS INPUT. (MAKE SURE YOU SAVE THE FILE UNDER The Policy and Procedure Manual sections relating to travel can be found ANOTHER on the web at: SO THE FORMULAS ON THE ORIGINAL ARE UNAFFECTED.) NAME http://www.mrak.ucdavis.edu/web-mans/ppm/contents.htm#300

Page 1

UNIVERSITY OF CALIFORNIA, DAVIS TRAVEL EXPENSE VOUCHER U85
AN ADVANCE WAS GIVEN (IF YES SEE BOX 20) PAY CORPORATE VISA (NO DaFIS DOC IS REQUIRED)
$

HOME CAMPUS

CITY OF RESIDENCE

REV. E, 8/1/03 DATE

Davis
UNIVERSITY EMPLOYEE YES
$

2/9/2008
US CITIZEN YES NO
$

REIMBURSEMENT FROM NON-UC SOURCE YES LIST IN REMARKS SECTION AND SUBTRACT FROM TOTAL CLAIM UC-EMPLOYEE NUMBER OR NON-UC EMPLOYEE SSN NO

NO

REIMBURSE TRAVELER

DaFIS DOC #:

NON-UC EMPLOYEE: HOME ADDRESS IF DIFFERENT FROM ABOVE

(25-42)

Name & Check Mailing Address

Trang Le
NAME AND CHART/NUMBER OF ACCOUNTS TO BE CHARGED

Komen - Asian Breast Health Program
PURPOSE AND DESTINATION OF TRIP

Clinics (Clinical Breast Exam, Pap smear, Mammography), Meetings, and Health Fair
fold here
1. MONTH/YEAR

COMPLETE THIS SECTION WHEN PRIVATE CAR USED VEHICLE LICENSE NO. 9. TRANSPORTATION DOES CAR USED HAVE LIABILITY INSURANCE? 15 13
COST OF TRANSPORTATION

YES
$

NO

4. SUBSISTENCE 5 6 LOCATION WHERE EXPENSES INCURRED 7 COST OF MEALS / INCIDENTALS 8 COST OF LODGING BETWEEN WHAT POINTS 10

16
REGISTRATION FEE, FOREIGN TRAVEL,

11
PRIVATE CAR MILEAGE

12

14 TYPE USED
PARKING, TOLLS CARFARE, TAXI, BAGGAGE, ETC.

2
TIME OF DEPARTURE AND RETURN

3 DAY

FOREIGN PER DIEM HOURS

TOTALS

BUSINESS, OTHER EXPENSES

TYPE

COST

US Bank Finance Fees
17. TOTAL HOURS DAYS: FOREIGN TRAVEL 18. RECAP US BANK VISA EXPENSES A. VISA CHARGES B. VISA CASH ADVANCE(S) (include any ATM fees in this figure) B.1.VISA Finance Fees (automatically calculated on B.) C. VISA FIRST CHECK(S) C.1.VISA Finance Fees (automatically calculated on C.) (18A,B,C) TOTAL US BANK VISA ACCT EXPENSES HRS:
3 UP TO 9 HRS. = 1/4 DAY 9 UP TO 15 HRS. = 1/2 DAY PER DIEM NOT ALLOWED WHEN TOTAL TRIP UNDER 21 HOURS
TOTAL DAYS TO NEAREST QUARTER

0.00
AUTHORIZED PER DIEM

0
AMOUNT

0.0 15 UP TO 21 HRS. = 3/4 DAY
21 UP TO 24 HRS = 1 DAY

0

X

=

0.00

19. REMARKS:

0.00 0.00 $0.00 20. ADVANCES
20A. DIRECT CHARGE ADVANCES
CASH REGISTRATION FEE HOTEL DEPOSIT DaFIS DOC # DaFIS Doc # DaFIS Doc # DaFIS Doc # AMOUNT AMOUNT AMOUNT AMOUNT $0.00 TOTAL 22. TOTAL EXPENSES LESS VISA ACCT TOTAL (18A,B,C) LESS DAFIS ADVANCES (20A) AIRFARE ADVANCE (20B) TOTAL ADVANCES

21. I CERTIFY THAT THE ABOVE IS A TRUE STATEMENT, THAT THE EXPENSES CLAIMED WERE INCURRED BY ME ON OFFICIAL UNIVERSITY BUSINESS ON THE DATES SHOWN, AND THAT I HAVE ATTACHED ORIGINAL RECEIPTS FOR EACH EXPENSE OF $75 OR MORE, AS REQUIRED BY UNIVERSITY POLICY. TRAVELER SIGNATURE: DATE:

23. AUTHORIZING SIGNATURE:

DATE:

OTHER

24. BALANCE DUE

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00

20B. AIRFARE ADVANCE
TYPE OR PRINT NAME & TITLE: CTS AIRFARE AMEX AIRFARE AMOUNT AMOUNT TOTAL $0.00

If money is due the university, from an underutilized advance, see the Instructions tab for the proper procedure. If a negative balance exists for Visa charges, they must be paid directly to US Bank.

25. FORM PREPARED BY:

TEL

(209) 406-2223

EXT.

ACCOUNTING OFFICE APPROVAL

Trang Le

EMAIL

tttle@ucdavis.edu

ORIGINAL
Send signed original to Accounts Payable (+ 1 copy if address is different from DaFIS address) 1 copy to traveler 1 copy for department files

INS TRUC TIO NS Month/Year. Enter the month(s) and year in which the expenses were incurred. Time. Enter the time of departure on the first day and the time of return on the last day of the trip. Enter the day on which the expenses were incurred. Subsistence. Subsistence expenses incurred within the vicinity of an employee’s campus or residence will not be reimbursed, nor will subsistence expenses for travel that occurs wholly bet ween 7:00 a.m. and 7:00 p.m. in a vehicle single day. The original of all receipts must be submitted for each meal or incidental expenditure of $25 or more. Daily meal and incidental expense reimbursements will be limited to the cap amount set forth in the University ’travel policy. Original receipts must be submitted for all lodging expenditure regardless of the amounts incurred. Foreign Travel Per Diem Hours. Enter on the same line as the date, the total hours away from headquarters applicable to foreign travel, i.e., travel outside the continental United States, Alaska, Hawaii, Puerto Rico, and other U.S. possessions. A full per diem allowance may not be claimed when the duration of the trip is less than 21 hours. Lodging or meals reimbursed separately, or furnished to the traveler without charge, should be explained in the Remarks section and the appropriate amount subtracted from the per diem claim in the Totals column on the right. Per Diem reimbursements calculated at more than one daily rate may be computed in the Remarks section or on an attached sheet. Receipts are not required when claiming per diem for foreign travel. Location. Enter the name of the city, town, campus, station, etc., where the lodging expenses were incurred. Cost of Meals and Incidentals. Enter the total amount incurred each day for meals and incidentals. Incidental expenses include laundry, cleaning and pressing of clothes, and tips and fees for services, such as for waiters and baggage handlers. Meal and incidental reimbursements may not exceed the daily cap amount specified under the travel policy. (Omit when claiming per diem for foreign travel.) Cost of Lodging. Enter the cost of lodging incurred for the trip. (Omit when claiming per diem for foreign travel.) Transportation. All travel must utilize the most economical mode of Transportation and the most usually traveled route consistent with the authorized purpose of the trip. Commuting expenses are not reimbursable. However, with respect to official University travel, mileage may be reimbursed for travel bet ween the employee’s residence and the common carrier or destination if the travel originates or terminates before or after the employee’s working hours, or during a regularly scheduled day off. Otherwise, mileage shall ordinarily be computed bet ween the traveler’s headquarters and the common carrier of destination. Between What Points? Enter the name of the city, town, campus, station, etc., associated with the travel origination, destination, and ret urn points. Round trips may be designated by “RT” following the travel origination and destination points. Private Car Mileage. Enter the total number of miles driven for business purposes. Any substantial deviations from the distance shown in a standard highway mileage guide must be explained in the Remarks section. Private car mileage shall be reimbursed in accordance with the standard or optional mileage rate provided under the University’s travel policy. Calculate the reimbursement once based on the total mileage of the trip. Passengers who are University employees must be listed in the Remarks section. Cost of Transportation. Enter the amount claimed for the cost of transportation. When claiming private car mileage, sho w which cents-per-mile rate was used in the Remarks section. Receipts are required for each transportation expense of $25 or more except for private car use. Charges for optional insurance, including collision damage waiver, on rental Cars driven in the United States are not reimbursable. When a standard transportation allowance is claimed in lieu of actual expenses, explain in the Remarks section (e.g., economy airfare and related expenses claimed when a more expensive method of transportation or an indirect routing is used for the convenience of the traveler). For private airplanes (prior approval required), use the Remarks section to show the total “airway mileage” per trip and the computation of the amount claimed. Type Used. Enter the type of transportation used in connection with each amount claimed in the Cost of Transportation column. PC Private car A Airline including connecting helicopter Inter-city bus Railway Other, explain in Remarks

RC UC SC

Rented car University car St ate car

B R O

Parking Tolls, etc. Enter the daily totals for amounts claimed for parking, baggage, checking; bridge, ferry, and road tolls; local bus, streetcar, taxi, or limousine; fuel, oil (rented or University-owned vehicle only). Registration Fee, Foreign Travel, Business, and Other Expenses. Enter the type of expense as provided below or use an asterisk (*) to reference the expense in the Remarks section. Enter the applicable amount in the Cost column.

Travel Expense Form (U85) Check List
Note: The Policy and Procedure Manual sections relating to travel are available on the w eb at: http://www .mrak.ucdavis.edu/w eb-mans/ppm/contents.htm#300

Before you begin:

Obtain all of the necessary receipts (Original receipts are required for all reimbursable charges other than local transportatio expenses, or meals & incidental expenses of less than $75.) Compare requested meal and lodging expenses to limits designated by trip duration (these can be found on the web at http://travel.ucdavis.edu/travelguide/policies.cfm#reimburse) Indicate how the reimbursement will be made: o Should it be made to the traveler, to the traveler’s corporate Visa, or both (mark both boxes)? o Include the DaFIS document number (if applicable) Provide complete information on the traveler: o Their complete name and remit-to address o The who, what, when, where, and why of the travel o o

Things to remember when completing the document:

o

Their UC employee number or Social Security number (if a non-UC employee) The vehicle license number (if private vehicle used) and answer the insurance question If a private vehicle is used in lieu of air transportation, an explanation and comparable airfare amount must be give section

Provide itemized details of the trip: o The date and time of both the departure and the return using either format HH:MM PM or HH:MM (Military time) enter 06:30 PM or 20:30.) o Lodging, meals, or miscellaneous expenses claimed individually, on the day they were incurred. (Lodging should b room & tax only, itemized by each day and not lumped together. Any other reimbursable expense(s) from the lodg claimed in another area of the form.) o Note any direct billed airfare (CTS or AmEx BTA) in section 20B If foreign per diem or currency conversion claimed, use the Remarks section to list the web sites used. (The foreign per die conversions should be obtained from the links provided at http://travel.ucdavis.edu/.) If an advance (such as Cash, Hotel, Registration, etc.) was given, include the DaFIS document number and amount in box 2 Attach all of the following (where applicable) be fore sending to Accounts Payable: o Original receipts as required (see “Before you begin:” above) o Approved Group Leader authorization o A copy of the previous travel expense form if the current form is a supplemental for the same trip o Exception approval for any expenses outside of policy o A check payable to UC Regents (see “Balance Due” section of form) The traveler must revie w and sign the form for ce rtification Obtain the authorizing signature from the travele r’s department he ad, supervisor, etc

Upon completion, prior to submission:

 

Plea se note: It is the responsibility of the department to ensure appropriate review of documents and compliance with campus policy. See U PROCEDURE MANUAL, Section 330-10 - Approval Authorization, Section IV. Procedures, C. Implementation of Necessary Reviews

t

ilable on the w eb at: #300

es other than local transportation, miscellaneous

an be found on the web at

h boxes)?

ion le airfare amount must be given in the remarks

PM or HH:MM (Military time) (i.e., for 6:30 PM

ere incurred. (Lodging should be claimed for actual sable expense(s) from the lodging stay must be

sites used. (The foreign per diem rates and currency

nt number and amount in box 20A

the same trip

pliance with campus policy. See UCD POLICY &