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This form is not to be used for Travel Advances. PLEASE INDICATE EMPLOYEE STUDENT TYPE OF STUDENT PAYMENT BANNER ID NAME DATE HOME MAILING ADDRESS DEPT BUSINESS PURPOSE DATE S DETAILED DESCRIPTION OF PAYMENT REQUEST INDEX ACCOUNT TOTAL DOLLAR AMOUNT Lodging expenses are limited to a maximum daily rate of 275 for Domestic and 325 for international. Meal expenses are limited to a maximum of 86 per day including gratuities with receipts 46 without receipts. Auto Mileage reimbursement rate is currently. 56 cents a mile as of Jan 2014. Signature Claimant Date Dept Ext Signature Approver Date Dept Ext APPROVER - My signature authorizes that I have performed the necessary review to validate the amount and type of payment as an appropriate business expense and that it conforms to all Yeshiva University Sponsored and Non-Sponsored guidelines. 0000000 PR EMPLOYEE/STUDENT PAYMENT REQUEST FORM Please attach all receipts taped to a letter size page and applicable documentation* If request is to be paid by Sponsored Research funding it requires additional approval from the office of Sponsored Research Resnick Campus Belfer Room 1108. Forward this form to the nearest Accounts Payable office after all required approvals have been obtained* Please fill out all fields as applicable. Incomplete forms including those with missing documentation will be returned and delay processing* We encourage employees to utilize their P-card so as to minimize personal reimbursements. Contact the E-commerce department within Procurement Services for P-card information ecommerce yu. edu. This form is not to be used for Travel Advances. PLEASE INDICATE EMPLOYEE STUDENT TYPE OF STUDENT PAYMENT BANNER ID NAME DATE HOME MAILING ADDRESS DEPT BUSINESS PURPOSE DATE S DETAILED DESCRIPTION OF PAYMENT REQUEST INDEX ACCOUNT TOTAL DOLLAR AMOUNT Lodging expenses are limited to a maximum daily rate of 275 for Domestic and 325 for international* Meal expenses are limited to a maximum of 86 per day including gratuities with receipts 46 without receipts. Auto Mileage reimbursement rate is currently. 56 cents a mile as of Jan 2014. Signature Claimant Date Dept Ext Signature Approver Date Dept Ext APPROVER - My signature authorizes that I have performed the necessary review to validate the amount and type of payment as an appropriate business expense and that it conforms to all Yeshiva University Sponsored and Non-Sponsored guidelines. Requestor information Name Email Dept. /Room Dept Ext Special Delivery Instructions Unless indicated payment will be mailed to home address or processed through direct deposit if authorized* Sponsored Research Review Finance Review over 5 000 AP Review Tax Review msc 8/1/11. 0000000 PR EMPLOYEE/STUDENT PAYMENT REQUEST FORM Please attach all receipts taped to a letter size page and applicable documentation* If request is to be paid by Sponsored Research funding it requires additional approval from the office of Sponsored Research Resnick Campus Belfer Room 1108. Forward this form to the nearest Accounts Payable office after all required approvals have been obtained* Please fill out all fields as applicable..

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