Nasaa Travel Expense Reimbursement Request Form
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1
2NASAA TRAVEL EXPENSE REIMBURSEMENT REQUEST FORM
If a written request is received from an appropriate public official and such request sets forth a valid reason for the
inspection of this report, such inspection will be permitted.
Read the Travel and Reimbursement Policies of the Association prior to preparation.
1.
Reimbursement
Requested by: _________________________(NAME OF CLAIMANT)_______________________________
2.
Reimbursement to
be mailed to:
_______________________(ADDRESS OF CLAIMANT)______________________________
STREET
_____________________
_______________________
_________________________
CITY
STATE/PROVINCE
POSTAL CODE
4.
Date claimant received notice to attend meeting:
______02/15/97____________
5.
Date claimant ordered airline ticket:
______03/01/97____________
6.
Date airline ticket actually issued:
______03/13/97____________
7.
A
B
C
D
E
F
G
H
COMMITTEE AND
DATE(S)
AIR FARE
LODGING
GROUND
PER DIEM
OTHER
TOTAL
MEETING LOCATION
TRANS.
NAME OF YOUR
COMMITTEE
04/01/97
358.00
122.49
27.50
16.49
2.00
526.48
WASHINGTON, DC
04/02/97
122.49
36.50
158.99
04/03/97
122.49
28.34
5.50
156.33
04/04/97
122.49
35.90
158.39
04/05/97
28.00
7.50
5.00
40.50
358.00
489.96
55.50
124.73
12.50
1040.69
TOTALS
8.
Signature of
Claimant:
___________(signature)___________________
Date:
_______04/10/97___________
AFTER PREPARATION, FORWARD THE CLAIM TO THE APPROVING INDIVIDUAL.
9.
Individual approving:
_____(signature)___________________
Date:
_______04/15/97___________
FORWARD CLAIM TO:
NASAA
750 First St NE, STE 1140
WASHINGTON, DC 20002
ATTN: JOHN LYNCH, DIRECTOR OF FINANCE
EXPENSE REPORTS MUST BE SUBMITTED WITHIN 30 DAYS OF THE END OF THE MEETING OR OTHER
TRAVEL. REPORTS SUBMITTED LATE REQUIRE SPECIAL APPROVAL BY THE PRESIDENT.
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