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UNC Carolina Population Center
 

CPC Travel Reimbursement

 

CONDITIONS

  • Deliver receipts to Kaitlin Dean (Room 205 West) immediately following submittal of this form.
  • Submit ALL receipts including airfare, hotel, parking, and business-related travel expenses.
  • Tape (no staples or glue) small receipts with no overlapping to 8.5 x 11 sheet(s) of white paper, one side only.
  • Receipts for meals are not required. Receipts for taxis under $20 are not required; provide date, destination, and cost.
  • If you shared a hotel room, try to get a separate statement for your amount.
  • If you use an electronic ticket for air travel, include your boarding pass and your flight confirmation with receipts.
  • If you don't have a receipt, do your best to obtain one from the hotel, airline, etc.; otherwise submit a signed memo describing the circumstances and the cost.

 

First Name:
 Last Name:
 Email Address:
Home Street Address:
 City:
 State:
 Zip Code:
CPC Phone:
 CPC Room:
 SS#: (optional)
Destination: (City, State/Country)
 Purpose of Trip: (please be specific - conference name, etc.)
 Begin Date:
 End Date:
CPC Account Number:
 Account Number:
 Account Number:
Did you get an advance for this trip? Yes   No
Deliver all receipts to Kaitlin Dean, Room 205 West.
Tape (no staples or glue) small receipts with no overlapping to 8.5 x 11 sheet(s) of white paper, one side only.
Airline Expense:
 Hotel Expense:
 Registration Fee:
Rental Car: Insurance NOT covered
Please provide justification
 Ground Transportation:
(Getting to the Airport, Taxis, etc.)
 Other Expenses:
 
Parking (Airport, Hotel, etc.):
 Mileage:
 Foreign Exchange Rate:
1 US Dollar = 
Time of Departure from Home/Office:
 Time Arrived at Destination:
 Number of Working Days in Trip:
Time of Departure from Destination:
 Time Returned to Home/Office: