Preparing the In-State Expense Voucher
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If the form is to be manually completed print out the
PDF format version of the In-State Travel form. If the form is to be completed
using Excel open the template version of the
In-State Travel form.
Print the sample form (PDF format) to review
while reading these instructions. Use your browser's back button to return
to this page.
The following information must be included on the A-14X (In-State Travel
Reimbursement) form:
- Insert the traveler’s full name.
- Insert the traveler’s social security number.
- Insert the traveler's vehicle make (Nissan, Chevrolet)
that was used.
- Insert the traveler's vehicle model (Altima,
Impala) that was used.
- Insert the year of the vehicle that was used.
- Insert the vehicle registration number of the vehicle
used. The vehicle registration number is the number on the plates issued to
you when the car was registered.
- Do not complete
this item (Leave Blank).
- Insert the insurance
policy expiration date of the vehicle used for travel.
- Insert the Department's name.
- Insert the
NEW Organization Code number to be charged. — Example:
WB3020 .
- Insert the dates that
travel took place.
- Insert the starting point and list all
destinations that will be claimed for reimbursement. Please be specific (i.e.,
from Knight campus, to Liston Campus to the Flanagan campus and returned).
Use separate lines if needed.
- Insert the vehicle odometer readings at beginning
and end of travel.
- Calculate miles
traveled by subtracting the beginning odometer reading from the ending odometer
reading. (Excel template version performs this calculation).
- Insert cost
of tolls and/or parking fees. Original receipts must be attached to travel
voucher.
- Calculate the total miles driven for the month.
(Excel template version performs this calculation).
- Calculate
the total dollar amount for mileage by multiplying the total mileage by the
current state reimbursement rate per mile (Excel template
version performs this calculation).
- The total of Other Charges is inserted in this space
(Excel template version performs this calculation).
- Compute the
grand total of the mileage and other travel costs (Excel
template version performs the calculation) Print the Excel version
of the completed form.
- Sign the voucher.
- Dept. head or supervisor must initial the travel
voucher at the bottom right hand side of the form.
Please be very careful when completing the form. If any of the above
required data is omitted, the form will have to be returned to the traveler
for correction.
NOTE: Original receipts for parking, tolls, etc.,
must be attached to form or a notation must be made if a parking meter is
used or if tokens are used.
Processing the completed A14X ( In State Travel voucher) form:
Once the A14X form has been completed and approved by the supervisor/dept.
chair person, it is sent to the Controller’s office at the Warwick Campus for
audit and processing. If you have any question please call the Controller’s
Office at 2150.
