REQUEST FOR TRAVEL REIMBURSEMENT - DCI '00: July 10 - August 4, 2000
Requester's Name: | _____________________________________________________________________ |
Home Address: | _____________________________________________________________________ |
_____________________________________________________________________ |
E-mail Address:_________________________________ Date of Travel/Visit(s): ________________ |
Please explain how this expense relates to funded project: |
__________________________________________________________________________________ |
__________________________________________________________________________________ |
From:________________ | To:________________ |
TRANSPORTATION: | AMOUNT |
| $___________ |
| $___________ |
| $___________ |
LOCAL TRANSPORTATION (Attach all original receipts) | |
| $___________ |
ACCOMMODATIONS | |
| $___________ |
| $___________ |
OTHER EXPENSES (Attach all original receipts) | |
| |
| |
| |
| $___________ |
Requester: | _________________________________ | Date Submitted: | ________________________ |
Signature |
Return reimbursement form and receipts to: |
DIMACS, CoRE Bldg., Rm. 406 Rutgers, The State University of New Jersey 96 Frelinghuysen Road Piscataway, NJ 08854-8018 Attn: Financial Assistant |
Questions? E-mail at financial-assistant@dimacs.rutgers.edu or call (732) 445-5928 (Note: reimbursements take approximately four weeks to process.)
For DIMACS Financial Department use only.
Approved by: _________________________________________ Date Approved: _______________