Travel Reimbursement - Request Form

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Preparer / Traveler Information

Preparer / Submitter(Required)

I am submitting on my own behalf

I am submitting on another's behalf

Traveler | UW Status(Required)

The relationship of the traveler to UW?

UW Employee (staff, faculty, etc.)

UW Student

Non-UW Employee (guest, visitor, employment candidate, etc.)

Preparer Name(Required)

First

Last

Preparer | UW Email(Required)

Name(Required)

Name of individual you are preparing on behalf of.

First

Last

Email(Required)

Email of individual you are preparing on behalf of.

Alternate Contact

In the event of your absence, who should be contacted?

First

Last

Alternate Contact UW Email

Alternate contact's UW email address

Affiliated UW Department/Unit(Required)

Universal Payee Requirement(Required)

Was the traveler/payee provided the UW Privacy Notice?

Yes

No

Citizenship(Required)

Is that traveler a U.S. Citizen or a Green Card holder?

Yes

No

Unit(Required)

APF Sub-Unit(Required)

ASA Sub-Unit(Required)

DCCS Sub-Unit(Required)

Enrollment Management Sub-Unit(Required)

Executive Office Sub-Unit(Required)

Home Station(Required)

The location where the traveler lives.

City

State

Duty Station(Required)

The location where the traveler works. For example: for UW Seattle, the station is Seattle, WA.

City

State

Non-UW | Email(Required)

Provide a non-UW email address for the traveler.

Enter Email

Confirm Email

Mailing Address(Required)

The mailing address for the Non-UW traveler receiving this reimbursement.

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

EO Assistance(Required)

Did you consult with or receive assistance from an Executive Office Finance team member prior to filling out this form?

No

Yes

Team Member Name

Who assisted you?

Trip Information

Trip | Pre-Travel Approval Form(Required)

Do you have an authorized Pre-Travel Approval form on file with the Executive Office Finance team?

No

Yes

Trip | Purpose(Required)

Trip | Purpose | Other(Required)

Trip | Conference, Event, Meeting | Name(Required)

Please spell out acronyms, if applicable

Trip | Conference, Event, Meeting | Website

Provide the website address that has information about conference/event/meeting registration fees, agenda, hotel, meals covered, etc.

Trip | Conference | Documentation Upload(Required)

Upload supporting documents related to conference registration, agenda, hotel, meals, etc.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Event | Start Date(Required)

Ex: First day of conference, event, or meeting.

Event | End Date(Required)

Ex: Last day of conference, event, or meeting.

Travel | Domestic or International(Required)

Domestic

International

Travel | U.S. Destination(Required)

City

State

Travel Approval Form

A completed Travel Approval Form must be provided for any domestic destination outside of WA, OR, or ID.

Travel Approval Form | Upload | Domestic(Required)

Required for domestic travel to a destination outside WA, OR, or ID.

Accepted file types: pdf, Max. file size: 15 MB.

Travel | International Destination(Required)

City

State / Province / Region

Country

Travel | Date & Time Departure(Required)

Provide the DATE and TIME of departure

Travel | Date & Time Return(Required)

Provide the DATE and TIME of departure

Travel Approval Form

A completed Travel Approval Form must be provided for any international destination.

Travel Approval Form | Upload | International(Required)

Required for international travel.

Accepted file types: pdf, Max. file size: 15 MB.

Personal Time(Required)

Did this trip include personal time - outside the business purpose of the trip?

No

Yes - Before OR after official purpose of trip

Yes - Before AND after official purpose of trip

Personal Time | Dates & Destination

Provide details for one or both stretch(es) of personal time.

Personal Time - Start Date	Personal Time - End Date	Location	Actions

There are no Personal Time Information.

Personal Time | Dates & Destination

Provide details for one or both stretch(es) of personal time.

Personal Time - Start Date	Personal Time - End Date	Location	Actions

There are no Personal Time Information.

Trip Information | Additional Information

Provide any additional details about your trip or travel circumstances that may not be reflected in the previous questions and may help with processing your reimbursement request.

Meals

Per Diem | Advance(Required)

Did you receive a per diem advance?

No

Yes

Per Diem | Advance Amount

Per Diem | Personal Meals(Required)

Are you claiming meal per diem?

No

Yes

Dates and Meals

Identify the meals for which you are seeking reimbursement.

Event Date	Meals	Actions

There are no Meals.

Meals Paid for Others(Required)

Did you pay for another's meal?

No

Yes

Per Diem | Meals for Others | Dates and Meals

Identify the meals for others that you paid for.

Meal Date	Meal(s)	Meal Total for the Day	Actions

There are no Meal Details.

Per Diem | Meals for Others | Receipt Upload(Required)

Itemized receipts are required when paying for meals on another's behalf.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Per Diem | Meals | Additional Information

Provide any additional details about your food per diem that may not be reflected in the previous questions and may help with processing your reimbursement request.

Per Diem | Lodging

Per Diem | Lodging(Required)

Did this trip require lodging?

No

Yes

Per Diem | Lodging Details

The number of nights must correspond with official event date(s) and/or travel dates. Lodging used while on Personal Time cannot be included.

# of Nights	Total Amount	Per Diem Overage	Actions

There are no Lodging Details.

Per Diem | Lodging | Folio or Receipt Upload(Required)

Upload the hotel folio (bill) or itemized final receipt.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Per Diem | Lodging | Additional Information

Provide any additional details about your lodging per diem that may not be reflected in the previous questions and may help with processing your reimbursement request.

Itemized Travel Expenses

Miscellaneous Travel Expenses Exception

A receipt is not required to be uploaded for certain miscellaneous travel expenses less than $75.

More info at UW Finance Receipts Policies.

Registration | Fee(Required)

No

Yes

Registration | Total(Required)

Registration | Receipt Upload(Required)

Receipt required for registration amounts over $75.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Airfare | Expenses(Required)

No

Yes

Airfare | Total(Required)

Airfare | Receipt Upload

Receipts required for airfare amounts over $75.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Comparison Airfare with Personal Time

Documentation is required that illustrates the difference in airfare price to accommodate personal time travel dates instead of official business travel dates. Be prepared to upload this documentation with this reimbursement request.

More info at UW Finance Travel Planning - Personal Time.

Comparison Airfare | Documentation Upload(Required)

Required when personal time is taken pre- or post-business event dates.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Baggage | Fees(Required)

No

Yes

Number of Bags(Required)

Baggage | Total(Required)

Baggage | Receipt Upload(Required)

Required when baggage fees total more than $75.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Car Service | Expenses(Required)

Taxi, Shuttle, Uber, Lyft, Town Car, Limo

No

Yes

Car Service | Total(Required)

Car Service | Receipt Upload(Required)

Required when any car service is utilized.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Rental Car | Expenses(Required)

No

Yes

Rental Car | Type(Required)

Rental car was a sedan

Rental car was NOT a sedan

Rental Car | Justification(Required)

Provide justification for not renting a sedan.

Rental Car | Total(Required)

More information about the Rental Car Documentation requirement on the UW Finance website.

Rental Car | Receipt Upload(Required)

Please upload car rental agreement and corresponding receipts.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Parking | Expenses(Required)

No

Yes

Parking | Total(Required)

Parking | Receipt Upload(Required)

Receipt required if over $75.

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Personal Vehicle | Mileage(Required)

Are you claiming mileage for using a personal vehicle?

No

Yes

Personal Vehicle | Mileage Total(Required)

Mileage Documentation

Upload Google Maps mileage confirmation. More info at UW Finance Mileage Policy.

Personal Vehicle | Mileage Verification(Required)

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Other Expenses(Required)

No

Yes

Other Expenses | Items & Costs

Row ID	Purchase Date	Item Purchased	Item Cost	Actions

There are no Miscellaneous Items.

Other Expenses | Receipt Upload

Drop files here or

Accepted file types: pdf, doc, docx, png, jpg, jpeg, Max. file size: 15 MB.

Perjury Statement - Missing Receipts

Missing receipts(Required)

Are you missing any receipts for individual purchases over $75?

No

Yes

Perjury Statement

For each missing receipt for purchases over $75, please complete and upload a
Perjury Statement (PDF) [UWNetID required] as an attestation for claiming reimbursement for a UW business expense.

Perjury Statement(s) Upload

One perjury statement required for each missing receipt.

Drop files here or

Accepted file types: pdf, Max. file size: 15 MB.

Travel Reimbursement Submission

Additional Information

Upload any additional documentation that would be helpful to EO Fin Team when reviewing this request.

Documentation Upload

Upload any additional documentation that would be helpful to the EO Fin Team when reviewing this request.

Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, Max. file size: 15 MB.

Submitter Signature(Required)