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UAB TRAINEE TRAVEL EXPENSE REIMBURSEMENT REQUEST Please complete one form per trip. Trainee Name Federal Tax ID Purpose of Trip Date Event Begins Date Event Ends Points of Travel Arrive Date Time From Via Mode Depart Date Time To Via Mode MM/DD/YYYY H MM am/pm City State PrivateCar RentalCar Plane Train Etc. Transportation -Private Car Mileage Not rental cars miles. per mi. IRS rate -Airfare/Trainfare Coach class only. Attach ticket stub and proof of payment. -Rental Car Including gasoline. Give justification for why rental car was used instead of public transportation* Attach original receipts. -Taxi/Van Including tips. Detail* Attach original receipts for fares. -Parking and tolls Detail* Attach original receipts. Total Transportation Trainee s Meals Must attach original receipts. Cannot include any alcoholic beverages. Date Breakfast Lunch Dinner Day Total Total Meals Trainee s Hotel Room Basic single occupancy room rate. Attach original receipts. Miscellaneous -Baggage Handling Tips Receipts not required* Total Reimbursement Requested Certification I hereby request reimbursement of the travel expenses detailed above and do hereby certify that these expenses were incurred by me these expenses are directly related to my official UAB trainee travel these expenses are in compliance with UAB s Expenditure Guidelines for Trainee Travel there are no alcoholic beverages included in these expenses UAB has not previously paid for any of these expenses and I have not been nor will I be reimbursed for this expense by any other party. per mi. IRS rate -Airfare/Trainfare Coach class only. Attach ticket stub and proof of payment. -Rental Car Including gasoline. Give justification for why rental car was used instead of public transportation* Attach original receipts. Give justification for why rental car was used instead of public transportation* Attach original receipts. -Taxi/Van Including tips. Detail* Attach original receipts for fares. -Parking and tolls Detail* Attach original receipts. -Taxi/Van Including tips. Detail* Attach original receipts for fares. -Parking and tolls Detail* Attach original receipts. Total Transportation Trainee s Meals Must attach original receipts. Cannot include any alcoholic beverages. Total Transportation Trainee s Meals Must attach original receipts. Cannot include any alcoholic beverages. Date Breakfast Lunch Dinner Day Total Total Meals Trainee s Hotel Room Basic single occupancy room rate. Date Breakfast Lunch Dinner Day Total Total Meals Trainee s Hotel Room Basic single occupancy room rate. Attach original receipts. Miscellaneous -Baggage Handling Tips Receipts not required* Total Reimbursement Requested Certification I hereby request reimbursement of the travel expenses detailed above and do hereby certify that these expenses were incurred by me these expenses are directly related to my official UAB trainee travel these expenses are in compliance with UAB s Expenditure Guidelines for Trainee Travel there are no alcoholic beverages included in these expenses UAB has not previously paid for any of these expenses and I have not been nor will I be reimbursed for this expense by any other party..

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