Travel Claim Form

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• Instructions
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Expense accounts are to be submitted at least once a month and not more often than twice a month, except where the amount claimed is less than $10, the claim need not be submitted until it exceeds $10 or until June 30, whichever occurs first. Requests for reimbursement of out-of-state travel expenses must be claimed separately. Requests for reimbursement of travel expenses which are incurred in different fiscal years must be claimed separately. A brief statement, one line if possible, of the purpose or objective, of the trip must be entered on the line immediately below the last entry for each trip. If the claim is for several trips for the same purpose or objective, one statement will suffice for those trips. Vouchers which are required in support of various expenses must be arranged in chronological order and attached to the claim. Each voucher must show the date, cost, and nature of the expense.

MULTIPLE PAGES--If your claim is more than one page, indicate page number and total number of pages. DO NOT total each page. Use subtotals and enter the total amount of the claim on the last page of the claim in the space for "TOTALS" and "CLAIM TOTAL."

1. MONTH/YEAR--Enter numerical designation of month and last two digits of the year in which the first expenses shown on the form were incurred.
2. DATE/TIME--Enter date and time of departure on the appropriate line. Show time of departure on date of departure, show time of return on the date of return. If departure and return are on the same date, enter departure time above and return time below on the same line. Where the first date shown is a continuation of trip, enter "Continuing" above that date, and where a trip is continuing beyond the last date shown, write "Continuing" after the last date.
3. LOCATIONS WHERE EXPENSES WERE INCURRED--Enter the name of the city, town, or location where expenses were incurred. Abbreviations may be used.
4. LODGING--Enter the actual cost of the lodging. A receipt is required for any expenditure of $25 or more.
5. MEALS--Enter the actual cost of each meal not to exceed the maximum amount for each meal as authorized by current CSU Internal Regulations Governing Travel Expenses and Allowance Manual on the California State University website. Dinner column is to be used to claim dinner on regular travel, overtime meals, and long term, noncommercial and relocation daily meal expenses.

OVERTIME MEAL AND BUSINESS RELATED MEAL--Enter the actual cost of the meal not to exceed the maximum amount authorized by current DPA regulations, and bargaining agreements. Overtime meals are reported to the IRS.

6. INCIDENTALS--Enter the total actual cost of incidentals not to exceed the maximum amount authorized by CSU Internal Regulations Governing Travel Expenses and Allowance Manual on the California State University website.
7. TRANSPORTATION--Purchase the least expensive round-trip or special rate ticket available. Otherwise the difference will be deducted from the claim. If you travel between the same points without using round-trip tickets, an explanation should be given.
1. COST OF TRANSPORTATION--Enter the cost of cash purchase of transportation. Show how transportation was obtained if fare was not purchased for cash. Use "CC" for credit card and "C" for cash. If transportation was paid by the State, enter method of payment - CR = charge request, TA = travel advance. Attach all passenger boarding passes.
2. TYPE OF TRANSPORTATION USED--Enter method of transportation used. Use "R" for railway, "B" for bus, "A" for scheduled commercial airline, "RA" for rental aircraft, "DA" for department-owned aircraft, "PA" for privately owned aircraft, "PC" for privately owned car, truck or other privately owned vehicles, "SV" for specially equipped vehicle for the handicapped, "SC" for State vehicles, "RC" for rental vehicles, "T" for taxi, and "Bl" for bicycle. Supervisors shall not authorize the use of motorcycles on official State business, and no reimbursement will be allowed for motorcycles.
3. CAR FARE, TOLLS, AND PARKING--Enter carfare, bridge tolls, and parking charges: attach a voucher for any parking charge in excess of $10.00 for any one continuous period of parking.
4. PRIVATE CAR USE--Enter number of miles traveled and amount due for mileage for the use of privately owned automobiles as authorized by current agreements, regulations, and detailed in CSU Internal Regulations Governing Travel Expenses and Allowance Manual on the California State University website.
8. BUSINESS EXPENSE—Enter conference or registration fees, printing or fax charges. Claims for phone calls must include the place and party called. If charge exceeds $2.50, support by vouchers or other evidence is required. Emergency purchases of equipment, clothing or supplies and all other charges require receipts and an explanation. In cases where receipts cannot be obtained or have been lost a statement to that effect shall be made in the purpose of trip section explaining the reason for the receipt being lost. All transaction without a receipt will only be reimbursed up to $25.
9. ENTER TOTAL EXPENSES FOR DAY
10. ENTER SUBTOTALS OR TOTALS
11. PURPOSE OF TRIP. REMARKS OR DETAILS--Explain need for travel and any unusual expenses. Enter detail or explanation of items in other columns, if necessary. Vouchers must be provided for any miscellaneous item of expense.
12. DEFENSIVE DRIVING #’S—If you do not have one call Safety & Risk Management (x6320)
13. PRIVATE VEHICLE LICENSE NUMBER--Enter license number of the privately owned vehicle used on official State business. To claim reimbursement, you must have a form 261 on file, pertaining to operator requirements, vehicle safety, seat belt usage and authorization.
14. MILEAGE RATE CLAIMED--Enter the rate of reimbursement being claimed for private vehicle use.
15. CLAIMANTS CERTIFICATION AND SIGNATURE--Your signature certifies that expenses claimed were actually incurred and that the cost of operating is at or above the rate claimed.
16. SIGNATURE OF OFFICER APPROVING PAYMENT--Certifies and authorizes travel: approves expenses as incurred on State business.
17. SIGNATURE OF AUTHORITY FOR SPECIAL EXPENSES--When a claim for conference or convention expense of $500.00 or more than 2 persons attend the same conference or convention, or when reimbursement of a business expense exceeds $25.00 or when reimbursement for Bar dues or license fees is included, the signature of the approving Cabinet officer is required, either on a separate document attached to this claim or by signature in this block.

The information Practices Act of 1977 (Civil Code Section 1798.17) and the Federal Privacy Act (Public Law 93-579) require that the following notice be provided when collecting personal information from individuals.
AGENCY NAME: Appointing powers and the State Controller's Office (SCO).

AUTHORITY: The Chancellor's office of the California State Universities establishes rules and regulations which define the amount, time, and place that expenses and allowances may be paid to representatives of the State while on State business.

PURPOSE: The information you furnish will allow the CSU Bakersfield, Accounting Office to reimburse you for expenses you incur while on official State business.

OTHER INFORMATION: While your social security account number (SSAN) and home address are voluntary information under Civil Code Section 1798.17, the absence of this information may cause payment of your claim to be delayed or rejected. You should contact the Accounting Office to determine the necessity for this information.