University System of New Hampshire
Financial and Administrative Procedures

PERSONAL REIMBURSEMENT FORM
Procedure 07-120
Issued By: Controller
Issued Date: 12/1/99
Revised Date: 10/1/03

Instructions for Completing the Personal Reimbursement Form

Employee/Trip Information
	INV #	The INV number is completed by your BSC.
	Name	Enter the name of the person traveling or the person responsible for the group.
	Position/Title	Enter your position or title.
	Department	Enter the name of your department, for instance, Chemistry or English.
	Phone	Enter your campus phone number, or a number where you can be reached at during business hours.
	Depart Date & Time	Enter the date and time you began your trip. The depart date is a required entry. Enter the date in MM/DD/YY format.
	Return Date & Time	Enter the date and time you returned from your trip.
	Destination	Please provide a brief description of where you traveled.
	For Non-Employee	For non-employees, please enter your Social Security Number and mailing address.
	Project/Grant	If your travel was related to a project or grant, please enter the name of the project/grant or contract here.
	Business Purpose	Please enter the business purpose for your travel.
	Date	Enter your travel dates in MM/DD/YY format. The day of week will be calculated for you. If your trip was longer than seven days, you will need to use an additional reimbursement form.
Employee Paid Expenses
	Auto Rental	Enter the daily amount spent on auto/van rental.
	Taxi/Tolls/Parking	Enter the total amount spent on taxi, tolls and/or parking each day. Receipts are only required for amounts greater than $25.00.
	Air/Bus/Train Fare	Enter the amount you spent on airfare, bus or train fare. Do not include airfare or bus fare that was charged to the University's Business Travel Account through your BSC. This is only for amounts you paid for personally.
	Telephone/Fax	Enter the daily amount spent on telephone calls or faxing for business purposes. Please refer to Procedure 7-013, Miscellaneous Reimbursable Travel Expenses , for allowable items.
	Lodging	Enter the total daily amount for your lodging. Include all related taxes such as room, city, state or county taxes. Do not include any personal costs such as in-room movies, etc. Please refer to Procedure 7-006, Lodging, for further details.
	Other	Enter the daily amount spent on other business related expenses such as copy services, laptop computer rentals, in-room safe, currency conversion fees, etc. Please refer to Procedure 7-013, Miscellaneous Reimbursable Travel Expenses , for allowable items.
Meals
	Per Diem Allowance	Enter the standard per diem meal allowance for your travel location. If you are choosing to claim less than the standard per diem rate, enter that amount here and DO NOT complete the Adjusted Per Diem Rate section. The Per Diem Method is required unless a specific exception has been approved.
	Adjusted Per Diem Rate	Use this section to indicate if meals were provided by other sources. For instance, those included with the conference registration, provided by a colleague or vendor, or being claimed in business expenses. Check off each meal that applies. If you choose to claim less than the standard per diem rate, enter that amount in the Per Diem Allowance and do not complete the Adjusted Per Diem Rate section.
	Daily Meal Total	The Daily Meal Total will automatically calculate based on the Per Diem Allowance and any meals provided for you by other sources. For example: A traveler attends a 3-day conference. The conference provides breakfast for all attendees on the second day of the conference at no charge to participants. Since the cost of breakfast is included in the conference registration fee, the traveler is not entitled to reimbursement for breakfast. Therefore, if the full-day rate is $35, the partial per diem allowed for the second day of the conference is $28 ($35 less $7).
Mileage
	Date	Enter the date is MM/DD/YY format. The mileage rate will calculate based on the USNH approved rate in effect at the time of travel.
	Departure, Destination & Purpose	Enter the places of departure and destination as well as busines purpose of the travel.
	Miles	Enter the number of miles traveled.
	Mileage Rate	The mileage rate will calculate based on the USNH approved rate in effect at the time of travel.
	Total	The total mileage amount is calculated based on the mileage rate and number of miles traveled.
Business Expenses
	Date	Enter the date of the business expense in MM/DD/YY format, i.e. 01/01/98.
	Description of Expense	Enter a brief description of the business purpose including who, what, where, and why.
	Amount	Enter the amount of the business expense.
Summary
	Total Expenses Paid by Employee	The total travel expenses paid by the employee automatically calculates.
	Original Amount of Advance	Enter the amount of your travel advance, if any.
	Amount Due to Employee/Amount Due to Cashier	The reimbursement form automatically calculates amount due to the employee, or the amount the employee owes USNH if advance exceeds expenses.
Accounting Information
	Vendor Code	Your BSC Representative will complete the vendor code during their review of your reimbursement form.
	Expense Distribution	If you know the sources of funding for your travel expenses, please enter it in this section.
	Advance	The USNH/UNH Travel Center will complete this information if applicable.
Approvals/Signatures
	Traveler	The traveler must sign the reimbursement to verify that all expenses were incurred by the traveler in fulfillment of duties to the University System of New Hampshire.
	Dean, Director, Dept. Head, Bus. Mgr.	Please secure the necessary approvals for this reimbursement.
	Authorized BSC Representative	Please secure the necessary approval for this reimbursement.
	Sponsored Research	If applicable, secure an approval from the Office of Sponsored Research.
	Travel Coordinator/Center	The BSC Travel Coordinator and USNH Travel Center must sign the form to verify that they have reviewed the document.