Travel Reimbursement Form

Traveler Name

Traveler Affiliation

Traveler Email Address

Traveler Home Address

Reimbursement checks will be mailed to this address.

Event

The event for which the traveler incurred expenses.

Trip Start Date

The date the traveler left their home (not the start date of the event).

Trip End Date

The date the traveler returned home (not the end date of the event).

Trip Destination

Expense Log (not including mileage)

Expense	Total
Airfare	Airfare Amount
Transit (Rail or Bus)	Transit Amount
Rental Car	Rental Car Amount
Taxi/Rideshare	Taxi/Rideshare Amount
Parking/Tolls	Parking/Tolls
Gas (Rental Car ONLY)	Gas (Rental Car ONLY) Amount
Meals and Incidental Expenses	Meals and Incidental Expenses Amount UC Davis will reimburse the actual cost of M&IE up to $79/day.
Lodging	Lodging Amount The maximum nightly rate for reimbursement is $333/night (not including taxes and fees).
Other	Other Amount Please explain in comments (below).
Total (not including mileage)	Total Amount 0

Mileage Reimbursement

Only fill out this section if:

You used your personal car for travel, and would like to receive mileage reimbursement; AND
You carry liability insurance for your car.

Unless you note otherwise in the comments (below), mileage will be calculated based on the shortest route between your departure and destination points using Google Maps. Mileage will be reimbursed at the current IRS standard mileage rate ($.67/mile as of 2024).

Starting Address

Destination Address

Comments

Receipts/Supporting Documentation

Receipts are required for any individual expenses greater than $75. Receipts must show proof of payment (usually the last four digits of the credit card used). If claiming Meals and Incidental Expenses, please attach receipts, a list of individual expenses, OR a list of daily totals spent (not to exceed $79/day).
Maximum 10 files.
10 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml.