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INSTRUCTIONS: Complete both pages of the form and then obtain Department Director's signature. If travel is out-of-state, City Manager's or designee's signature is also required. Once
approval(s) are received, submit a copy of the form to the Accounting Division by the appropriate deadline (see Travel Policy). Documentation such as registration form or mileage is
required.
I.
II.
III.
IV.
V.
VI.
TYPE OF TRAVEL/TRAINING/MEETING (check one)
AUTHORIZATION REQUESTED FOR
NAME
OTHER EMPLOYEES COVERED BY THIS AUTHORIZATION
NAME OF CONFERENCE/TRAINING OR PURPOSE OF TRIP
DESTINATION CITY
CITY OFFICIAL/EMPLOYEE TRAVEL/TRAINING ACKNOWLEDGEMENT
I agree to verify the appropriateness and accuracy of all travel/training expenses and to forward the Reconciliation Form along with supporting receipts to Accounting within 5 business
days of my return. I understand that failure to comply with the travel policy may result in either non-reimbursable expenses or a taxable reimbursement. I authorize the City to payroll
deduct the cash advance for pre-paid expenses listed on the following page if I fail to settle the amount within 60 days.
City Official/Employee
JUSTIFICATION FOR TRAVEL/TRAINING
FUND AVAILABILITY
Estimated Expenses (from Expenses Tab)
Travel Budget (GL # 436030 - 436090)
Less: Year-to-Date Expenditures
Budget available for this request
APPROVAL
Department Director Date
CITY OF IOWA CITY
TRAVEL AND TRAINING EXPENSE AUTHORIZATION FORM
** MUST BE COMPLETED AND APPROVED PRIOR TO TRAVEL **
STATE
DEPARTMENT/DIVISION
DEPART DATE
$
$
$
TIME
Date
0
City Manager (required for out-of-state travel) Date
EMPLOYEE ID#
PROJECT STRING
CONFERENCE/TRAINING DATE(S)
RETURN DATE
$
ORG CODE
TIME
0
ACTIVITY
Transportation
Airfare; Ticket Charge
City Vehicle (gas expense)
Private Vehicle -
Car Rental
Total Transportation
Lodging
If charges will include non-city employees, estimate for rate of equivalent single room only.
Total Lodging
Meals (write in dates and rates, per travel policy)
Date
Breakfast
Lunch
Dinner
Total
Registration (please attach copy of registration form)
If paying through Accounts Payable, please check one:
Accounting process through this travel authorization
Division will submit check request
Miscellaneous Expenses
VI. ADVANCE CHECK TOTAL - Accounts Payable Check Requested
Check payable to:
nights at $
0
(Attach another sheet if additional days are needed.)
Mail check Return check to
0
(Advances will not be issued for less than $50.00)
miles x
each.
0
$
$
$
TRAVEL/TRAINING AUTHORIZATION FORM
0.545
0
CITY OF IOWA CITY
0
Total Miscellaneous
0
0
Total Meals
Total Registration
Total Expenses
Date to be Issued:
A
To be
paid by Procurement Card
$
$
$
$
$
$
$
$
$
$
N/A
0
N/A
0
(Friday immediately prior to Departure Date)
B
To be
paid by Accounts Payable
$
$
$
$
$
$
$
$
$
$
N/A
0
N/A
0
C
Paid from
Travel Advance
or Out-of-Pocket
$
$
$
$
$
$
$
$
$
$
$
T-1
0
0
0
0
(Advance Amount)
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