Travel Expense Form

Date:
For Month of:

This form is designed to report travel expenses related to an assignment with Interim Ministries-ABC. (A) You are to report expenses for you and your spouse on the initial and last trips between your home and the assignment destination including: auto miles, tolls, parking, meals, and motels or public transportation when used. (B) You are to report professional use of auto while on assignment, including: miles, tolls, and parking. (C) Continuing Education and Regional Events are to be reported and reimbursed by way of a Scholarship Form. No other expenses are reimbursable unless pre-approved by the Interim Ministries-ABC Director.

NOTE: Totals are auto-calculated for mileage entries. For other entries, enter dollar amounts manually in the format #.## (with no $ sign and no commas).

  Date Miles Purpose Other Expense Amount ($)
1.
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20.
Total

Name:
Address (where check is to be sent):
City:
State:
Zip:

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