SOP 406.04-att-2: Travel Advance Authorization Form
Summary
Key Topics
- travel advance
- authorization form
- travel request
- employee travel
- meal expenses
- lodging
- transportation costs
- travel approval
- fiscal officer
- payroll deduction
- travel advance repayment
- business travel
- continuous travel
- in-state travel
- out-of-state travel
Full Text
SOP 406.04
Attachment 2
08/20/22
TRAVEL ADVANCE AUTHORIZATION FORM
|EMPLOYEE NAME|Col2|Col3|TITLE:|Col5|Col6|
|---|---|---|---|---|---|
|SOCIAL SECURITY
NUMBER
|ORG NUMBER|ORG NUMBER|AUTHORIZED BY: (Supervisor)|AUTHORIZED BY: (Supervisor)|AUTHORIZED BY: (Supervisor)|
|TRAVEL INFORMATION|TRAVEL INFORMATION|TRAVEL INFORMATION|TRAVEL INFORMATION|TRAVEL INFORMATION|TRAVEL INFORMATION|
|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|TYPE OF TRAVEL (CHECK ONE): ( ) SINGLE TRIP IN STATE ( ) SINGLE OUT OF STATE
( ) CONTINUOUS TRAVEL ( ) OTHER SPECIFY|
|2. PURPOSE OF TRIP|2. PURPOSE OF TRIP|2. PURPOSE OF TRIP|2. PURPOSE OF TRIP|2. PURPOSE OF TRIP|2. PURPOSE OF TRIP|
|3. DATE OF TRAVEL|3. DATE OF TRAVEL|4. DESTINATION|4. DESTINATION|4. DESTINATION|4. DESTINATION|
|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|5. METHOD OF TRAVEL ( ) Private Car ( ) State Car ( ) Commercial Air ( ) State Plane ( ) Other|
|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|ESTIMATED EXPENDITURES (if this authorization is for continuous travel, the estimated expenditures
should cover one pay period|
|Type of Expenditure|Type of Expenditure|Type of Expenditure|Anticipated Payment Method|Anticipated Payment Method|Anticipated Payment Method|
|
Meals|
Meals|
Meals|Credit Card|Cash|Total|
|
Meals|
Meals|
Meals||||
|Lodging|Lodging|Lodging||||
|Transportation|Transportation|Transportation||||
|Other Expenses (Specify)|Other Expenses (Specify)|Other Expenses (Specify)||||
|TOTAL|TOTAL|TOTAL||||
|||||||
|AUTHORIZATION|AUTHORIZATION|AUTHORIZATION|RECEIPT ACKNOWLEDGEMENT|RECEIPT ACKNOWLEDGEMENT|RECEIPT ACKNOWLEDGEMENT|
|Your approval requires that if a travel advance is not recoverable
from the employee, you are responsible for repaying the
Department.
Approved by: ___________________________________
Supervisor Date
Travel advance in the amount of
$_____________ hereby authorized.
_________________________________
Agency Fiscal Officer|Your approval requires that if a travel advance is not recoverable
from the employee, you are responsible for repaying the
Department.
Approved by: ___________________________________
Supervisor Date
Travel advance in the amount of
$_____________ hereby authorized.
_________________________________
Agency Fiscal Officer|Your approval requires that if a travel advance is not recoverable
from the employee, you are responsible for repaying the
Department.
Approved by: ___________________________________
Supervisor Date
Travel advance in the amount of
$_____________ hereby authorized.
_________________________________
Agency Fiscal Officer|I hereby acknowledge receipt of this travel advance,
and accept full responsibility for the safeguarding and
proper accounting for these funds, including lost or
stolen funds. I authorized the GDC, the Employee’s
Credit union, and/or Employee’s Retirement System to
deduct any outstanding travel advance amounts from
my account(s).I ALSO ACKNOWLEDGE THAT
THE TRAVEL ADVANCE IS DUE IN FULL
WHEN I LEAVE MY PRESENT POSITION.
Receipt of Check No.____________
______________________________
Employee Signature Date|I hereby acknowledge receipt of this travel advance,
and accept full responsibility for the safeguarding and
proper accounting for these funds, including lost or
stolen funds. I authorized the GDC, the Employee’s
Credit union, and/or Employee’s Retirement System to
deduct any outstanding travel advance amounts from
my account(s).I ALSO ACKNOWLEDGE THAT
THE TRAVEL ADVANCE IS DUE IN FULL
WHEN I LEAVE MY PRESENT POSITION.
Receipt of Check No.____________
______________________________
Employee Signature Date|I hereby acknowledge receipt of this travel advance,
and accept full responsibility for the safeguarding and
proper accounting for these funds, including lost or
stolen funds. I authorized the GDC, the Employee’s
Credit union, and/or Employee’s Retirement System to
deduct any outstanding travel advance amounts from
my account(s).I ALSO ACKNOWLEDGE THAT
THE TRAVEL ADVANCE IS DUE IN FULL
WHEN I LEAVE MY PRESENT POSITION.
Receipt of Check No.____________
______________________________
Employee Signature Date|
|Comments:|Comments:|Comments:|ACCOUNTING SECTION ONLY|ACCOUNTING SECTION ONLY|ACCOUNTING SECTION ONLY|
||||Posted by:___________________________|Posted by:___________________________|Posted by:___________________________|
||||Ref. #_________________________
Date:_____________________|Ref. #_________________________
Date:_____________________|Ref. #_________________________
Date:_____________________|
Retention Schedule: Upon completion, this form shall be maintained for the current year, plus five (5) prior years at the
Facility level, and for five (5) years following the end of the fiscal year at Central Office.