Moving Reimbursement Payroll Report Form Page 2

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MOVING REIMBURSEMENT PAYROLL REPORT
Employee: 0
0
Begin Date: ######
Move From:
SSN: 0
0
End Date: ######
Move To:
BU: 0
# of Days
Calculate
Rental
Per Diem
Calculated
Calculate
Commerc
Miles
Mileage
of Per
d
Car, Taxi,
Rate
Lodging
d Meals
ial Travel
Claimed
Rate
Diem
Taxable
etc.
(Earn: 372) (Earn: 373)(Earn: 372)
See AAM(Earn: 372)(Earn: 372)
PREMOVE:
Employee
0
$
100.00
$
-
$
-
$
-
0
$
0.325
$
-
$
-
Spouse
0
50.00
-
-
-
N/A
N/A
N/A
N/A
TOTAL
$
-
$
-
$
-
$
-
$
-
# of Days
Per Diem
Calculated
Calculate
Rental
of Per
Rate
Lodging
d Meals
Car, Taxi,
(Earn: 374) (Earn: 375)(Earn: 372)
TEMPORARY QUARTERS:
Employee
0
$
100.00
$
-
$
-
$
-
Spouse
0
50.00
-
-
N/A
Dependents
0
20.00
N/A
-
N/A
TOTAL
$
-
$
-
$
-
Commerc
Calculate
# of Days
ial Travel
Mileage
d
Calculate
Per Diem
Calculated
Calculate
Miles
of Per
(Inc.
Rate
Nontaxab
d Taxable
Rate
Lodging
d Meals
Claimed
Diem
Paid
Mileage
rental
le
car, etc.)
Mileage
( Earn: 381 )(Earn: 379)(Earn: 381)
(Earn: 381)(Earn: 371)
MOVE (en route):
Employee
0
$
100.00
$
-
$
-
$
-
0
0.325
$
-
$
-
Spouse
0
50.00
-
-
-
N/A
N/A
N/A
N/A
Dependents
0
20.00
N/A
-
-
N/A
N/A
N/A
N/A
TOTAL
$
-
$
-
$
-
$
-
$
-
Employe
State Paid
Misc
Total Cost by Type of Moving Expense
e Paid /
Commerci
Taxable
Reimburs
al Vendor
State
( 390 ) Not reportable
(Earn: 376)
HOUSEHOLD
Premove
$
-
GOODS:
$
-
$
-
OTHER:
$
-
Temp Qtrs
-
Move
-
HH Goods-Employee
-
HH Goods-State paid
-
Other
-
TOTAL
$
-
(This total must agree with total below)
NONTAXABLE
TAXABLE
Description
Earning Code Amount Earning CodeAmount
HH Goods - Employee 390
$
-
-
N/A
Total Cost by Tax Type
Move: Tvl & Lodging
381
-
371
$
-
Move: Meals
-
N/A
379
-
Nontaxable Column Total
$
-
Premove: Tvl & Lodging -
N/A
372
-
Taxable Column Total
-
Premove: Meals
-
N/A
373
-
Total Reportable
-
Temp Qtrs: Lodging
-
N/A
374
-
Nonreportable Costs
-
Temp Qtrs: Meals
-
N/A
375
-
TOTAL
$
-
Other Moving Exp
-
N/A
376
-
Column Totals:
$
-
$
-
Deductio
n Code
Amount the employee has been paid/reimbursed
$
-
AKPAY Batches: 00xx2 =
00xx3 =
Prepared by:
Date:
Division:
Dept. Review by:
Date:
May 16, 2000

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