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Internal
Trustee Travel Expense Report
KY - Board Expense Form
Part 1: Payee Information
Name
*
Municipality
*
Address (reimbursement will be sent to this location)
*
Address (reimbursement will be sent to this location)
Address (reimbursement will be sent to this location)
Address (reimbursement will be sent to this location)
City
City
State/Province
State
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Vermont
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Washington
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State/Province
Zip/Postal
Zip/Postal
Email
*
Purpose for Travel
*
Begin Travel Date:
End Travel Date:
Reimbursement Payable To:
*
Individual
Municipality
Part 2: Mileage
Total Miles Driven (round trip, must be greater than 100 miles per travel policy)
miles
(Reimbursement will be calculated automatically minus the first 100 miles driven.)
Total Mileage Expense
(.585 IRS Rate x Reimbursable Miles)
Part 3: Meals
Day 1 Breakfast
$
Day 1 Lunch
$
Day 1 Dinner
$
Day 1 Total
Day 2 Breakfast
$
Day 2 Lunch
$
Day 2 Dinner
$
Day 2 Total
Day 3 Breakfast
$
Day 3 Lunch
$
Day 3 Dinner
$
Day 3 Total
Day 4 Breakfast
$
Day 4 Lunch
$
Day 4 Dinner
$
Day 4 Total
Day 5 Breakfast
$
Day 5 Lunch
$
Day 5 Dinner
$
Day 5 Total
Total Meals Expense
(total of "Daily Total" column)
Part 4: Miscellaneous Travel Fees
(parking, taxi, hotel, etc.)
Description of Misc Travel Fee
Total Misc Travel Expense
Total Reimbursement
Part 5: Upload Receipts
File Upload
Drop a file here or click to upload
Choose File
Maximum file size: 20.48MB
Part 6: Acknowledgement
I certify that the above expenses were all incurred while conducting League business in accordance to any applicable travel polices set forth by the Michigan Municipal League and have provided any applicable receipts as support to my reimbursement.
Signature
*
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Date
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