Attachment 20 FEMA Post Travel Expense Summary.pdf

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Housing Inspection Services
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HSFE80-12-R-0033
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Attachment 20 FEMA Post Travel Expense Summary

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INSPECTOR POST TRAVEL EXPENSE SUMMARY

UCSC Post Travel Form Office Use Only FAST Office Use Only Enter all payments made to or on behalf of the traveler (Numeric values) Enter all payments made on behalf of the traveler Note: Personal non-disaster related travel expenses are not reimbursable.

NOTE: If traveler chooses to include personal travel, record times/dates based only on the business portion of the trip. Provide explanation of personal travel.

Description of Expense Description of Expense Column Total Expense Total Expense Column Airfare * Airfare Expenses POV Mileage Mileage Expenses Rental Car * (excludes insurance) Rental Car Expenses Excluding Insurance Other Transportation (Bus, Metro, Taxis etc.)

Other Transportation Expenses Parking/Tolls Parking and Toll Expenses Training Expenses * Conference Registration Expenses Lodging (room + tax only) * Lodging Expenses Per Diem, Meals & Incidental Exp.

Meals and Incidentals Expenses Inspections Completed Foreign Per Diem Expenses Misc. (laundry, phone, tips baggage etc) Long Term Expenses

TOTALS:

Miscellaneous Expenses Inspector's certification: I certify the above are actual expenses incurred by me while on official Government business per the dates shown, and that the original receipts are attached for each expense of $75.00 or more, per CFO Bulletin120.1 and Federal Travel Regulations.

Traveler's certification: I certify that the above is a true statement, that the expenses claimed were incurred by me while on official University business on the dates shown, and that I have attached original receipts for each expense of $75.00 or more, as required by University policy. I certify that the private vehicle driven has adequate liability insurance per UC policy (G-28).

< Less Payments on behalf of Traveler > Less payments on behalf of traveler text Due to Traveler

Comments Comments Header Last Name, First Name, Middle Initial Important: Form must be filled out in Adobe Reader 8 or above for form functionality Total from Add'l Pages Less cash advances given to traveler text Fund Organization Account Activity Amount Reimburse mileage - $.51/mile Access the GSA Per Diem Rates for reimbursement validation Can add an updated link here.

Revised 4/4/2012 (Enter numeric values only) ** Use additional forms for further expenses and explanations ** Use additional forms for further expenses and explanations

* Must submit original itemized receipts regardless of amount *Must submit original receipts.

Section J. Attachment 20

InspectorName:
InspectorPhone:
AddressLine1:
CityStateZip:
Destination:
ContractorName:
AirfarePrepaid:
TrainingPrepaid:
LodgingPrepaid:
TotalPrepaid:
TripNumber:
DocNumber:
VendorNumber:
DateDue:
e:
AirfareTotal:
CommentsAirfare:
Mileage:
Calculated Total Personal Car Mileage:
CommentsMileage:
RentalCar:
RentalCarTotal:
CommentsRentalCar:
Transportation:
TransportationTotal:
CommentsTransportation:
Parking:
ParkingTotal:
Training:
TrainingTotal:
Lodging:
LodgingTotal:
Meals:
MealsTotal:
InspectionsCompleted:
InspectionsCompletedTotal:
Misc:
MiscTotal:
TotalDay1:
TotalDay2:
TotalDay3:
TotalDay4:
TotalDay5:
TotalDay6:
TotalExpenseAll:
TotalAdditionalPages:
LessPayments:
PaymentDue:
PrintButton1:
ResetButton1:
SignatureDate:
SecondTierSignature:
SignatureDate1:
Signature:
ReturnTime:
ReturnDate:
DepartureTime:
DepartureDate:
InspectorNumber:
OtherAuthorizedSignature:
TravelerEmail:
CurrentDate:
Cell1:
Cell2:
Cell3:
Cell4:
Cell5:
DateTimeField1:
Reimburse:
ReimburseTotal:
OtherPrepaid:
DateTimeField2:

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