07 - 120 Instructions for Completing the Simplified Travel Reimbursement Form

Employee/Trip Information

[1]  INV # The INV number is completed by your BSC or campus travel center.
[2]  Name Enter the name of the person traveling or the person responsible for the group.
[3]  Position/Title Enter your position or title.
[4]  Department Enter the name of your department, for instance, Chemistry or English.
[5]  Phone Enter your campus phone number, or a number where you can be reached at during business hours.
[6]  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.
[7]  Return Date &  Time Enter the date and time you returned from your trip.
[8]  Destination Please provide a brief description of where you traveled.
[9]  For Non-
 Employee
For non-employees, please enter your Social Security Number and mailing address.
[10]  Project/Grant If your travel was related to a project or grant, please enter the name of the project/grant or contract here.
[11]  Business
 Purpose
Please enter the business purpose for your travel.
[12]  Date Enter your travel dates in MM/DD/YY format. The day of the 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

[13]  Auto Rental Enter the daily amount spent on auto/van rental.
[14]  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.
[15]  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.
[16]  Telephone/
 Fax
Enter the daily amount spent on telephone calls or faxing for business purposes. Please refer to Procedure 7-013, Misc. Reimbursable Travel Expenses, for allowable items.
[17]  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.
[18]  Other Enter the daily amount spent on other business related expenses such as copy services, laptop computer rentals, in-room safe, currency conversion fees, tax, tip, gas, bag fees, etc. Please refer to Procedure 7-013, Misc. Reimbursable Travel Expenses, for allowable items.

Meals

[19]  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.
[20]  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.
[21]  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 $49, the partial per diem allowed for the second day of the conference is $39 ($49 less $10).

Mileage

[22]  Date Enter the date in MM/DD/YY format. The mileage rate will calculate based on the USNH approved rate in effect at the time of travel.
[23]  Departure,  Destination &  Purpose Enter the places of departure and destination as well as business purpose of the travel.
[24]  Miles Enter the number of business miles traveled.
[25]  Mileage Rate The mileage rate will calculate based on the USNH approved rate in effect at the time of travel.
[26]  Total The total business mileage amount is calculated based on the mileage rate and number of business miles traveled.

Business Expenses

[27]  Date Enter the date of the business expense in MM/DD/YY format, i.e., 01/01/98.
[28]  Description of  Expense Enter a brief description of the business purpose including who, what, where, and why.
[29]  Amount Enter the amount of the business expense.

Summary

[30]  Total Expenses  Paid by  Employee The total travel expenses paid by the employee automatically calculates.
[31]  Original  Amount of  Advance Enter the amount of your travel advance, if any.
[32]  Amount Due to  Employee/
Amount  Due to Cashier
The reimbursement form automatically calculates the amount due to the employee, or the amount the employee owes USNH if the advance exceeds expenses.

Accounting Information

[33]  USNH ID Provide your USNH ID#.
[34]  Expense  Distribution Please enter the source(s) of funding for your travel expenses.
[35]  Advance The BSC or USNH/UNH Travel Center will complete this information if applicable.

Approvals/Signatures

[36]  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.
[37]  Dean, Director,  Dept. Head,  Bus.  Mgr. Please secure the necessary approvals for this reimbursement.
[38]  Authorized  BSC/Travel  Representative Please secure the necessary approval for this reimbursement.
[39]  Sponsored  Research If applicable, secure an approval from the Office of Sponsored Research.
[40]

 Travel  Coordinator/
 Center

The BSC or Campus Travel Coordinator must sign the form to verify that they have reviewed the document and approve the reimbursement as well as verify that all supporting documentation is provided. 

 


MILEAGE REIMBURSEMENT EXAMPLES

Example 1: An employee has a main office at GSC in Concord, NH but one day they have meetings at GSC – Littleton and GSC – Conway.  They never go to their main office. The employee would calculate their mileage from their home to the Littleton campus; plus the mileage from the Littleton campus to the Conway campus; plus the mileage from the Conway campus to their home. This total would be the business mileage driven and available for reimbursement.

Example 2: An employee lives in Weare and has a main office in Plymouth, NH. They have a morning meeting at the Keene campus and will return to their Plymouth office for the afternoon. The employee would calculate their mileage from their home to the Keene campus; plus the mileage from the Keene campus to their Plymouth office to arrive at the business mileage driven and available for reimbursement.

Example 3: An employee has a main office in Durham, NH. They have a lunch meeting at the Plymouth campus but will work from their Durham office before and after the meeting. The business mileage driven and available for reimbursement would be limited to their mileage from their Durham office to the Plymouth campus and back to their Durham office.

Example 4: An employee lives in Conway and has a main office in Keene. Their work schedule is such that they do not normally work on Wednesdays. On one particular Wednesday, they are required to travel to their Keene office for a staff meeting.  Because they are driving to their main office, they will not be eligible for mileage reimbursement.  This would also be the case if they were required to travel to their main office on a day they normally telecommute.

Example 5: An employee lives in Dover and has a main office at UNH Manchester. They have a lunch meeting at the Plymouth campus but will work from their Manchester office before the meeting. When the meeting is over, they decide to take the scenic route home so they can drive around Lake Winnipesaukee. The employee would calculate their mileage from their Manchester office to the Plymouth campus; plus the mileage from the Plymouth campus to their home. From this total they will deduct the personal miles driven, to see the Lake Winnipesaukee area, to arrive at the business mileage driven and available for reimbursement.

Example 6: An employee lives in Dover and has a main office at UNH School of Law in Concord, NH. They work from their Concord office in the morning and have an afternoon meeting in Durham. They will not return to their Concord office after the meeting. They will be eligible for reimbursement for the miles driven from their office, to the Durham meeting, to their home.

This page last updated Wednesday, September 28, 2016. For information on the adoption and effective dates of policies please see explanation on the OLPM Main Menu.