Date(s) of Travel
Event Location: (City/State)
LOC FUND SUB
Enter Total Miles
Approving Authority (Signature) Date Phone
BRC Travel & Business Entertainment Summary - Employee Reimbursement Form
NOTE: This is an estimate of reimbursement.
Actual reimbursement will be determined by UC policy.
HOTEL / LODGING
IMPORTANT: if parking, food & incidentals are included on
hotel bill do not double enter in categories below)
Enter Expenditures in
Depart City :
Expense Exceptions or Detail
UCOP - Business Resource Center
1111 Franklin Street, 9th Floor,
Oakland, CA 94607
PERSONAL CAR BUSINESS MILEAGE
- Enter total miles in detail below.*
Travel Expense Detail
Expenditures of $75 or above require original itemized receipts. Please secure all receipts with tape on 8 1/2 x 11 white paper in order of expense date & submit with this form.
Meals & Incidentals (totals carry over from page 2)
(M&I that is not included in hotel bill)
AIRFARE Other Fees
- e.g. baggage fees, change fees
Meeting/Conference (full name):
PURPOSE OF TRIP
Personal Travel part of this
trip? Yes No
(that is not included on hotel bill)
Entertainment (manually type in amounts from page 2 totals)
MILEAGE: *Estimated Mileage
(Rate X Miles)
Approving Authority Statement: I approve this commitment of department funds for the stated University purpose. I certify that it is an appropriate use for the fund source and that
the transaction complies with University policy.
Total Ground Transportation: (totals carry over from page 2)
List dates of personal travel (airfare comparison for business portion of travel required)
RENTAL CAR GAS
IMPORTANT: Please insert funds as appropriate indicating if expense was paid from personal funds, corporate card or
prepaid/direct bill. Please
enter any expense in more than one category below.
EXPENDITURES & REIMBURSEMENTS
*MILEAGE NOTE - As a general rule the basic mileage reimbursement guidelines are as follows:
Business travel on weekdays day or evening: UC reimburses business mileage in excess of normal commute expenses only.
Business travel on weekends or UC holidays: Report mileage from home to the destination using the most direct route.
Please see chart How mileage and ground transportation reimbursements are calculated for UCOP travelers for more detailed information