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Rockcastle County Schools | 245 Richmond Street - Mt. Vernon, KY 40456
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Travel Expense Reimbursement Request Form
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PERSONNEL
03.125 AP.22
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Employee Name:School/Department:
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Title:Name of Activity:
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Inclusive Dates of Activity: April 2023Location of Activity:
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Itemization of ExpensesDateDateDateDateDateTotal
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LODGING (Receipt Required)$0.00$0.00
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MEALS (Receipt Required)BreakfastBreakfastBreakfastBreakfastBreakfast$0.00
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Maximum Amounts:LunchLunchLunchLunchLunch
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Breakfast $10, Lunch $15, Dinner $20DinnerDinnerDinnerDinnerDinner
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TOTAL$0.00TOTAL$0.00TOTAL$0.00TOTAL$0.00TOTAL$0.00
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MILEAGE (Total miles x $0.53)To
Schools
ToToToTo$0.44
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List specific place(s) traveled to and fromFromC.O FromFromFromFrom0.0
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MileageMileageMileageMileageMileage
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REGISTRATION FEE
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(Receipt Required)
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MISCELLANEOUS
$0.00
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(Parking/tolls*/taxi/shuttle/etc)
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(Receipt Required)
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AIRLINE FARE
$0.00
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(Receipt Required)
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*Tolls (none for district vehicles being operated in state in an official capacity)
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(If a copy of the Out of District form approving the appropriate activities is not attached, this form will be returned without reimbursement being made.)
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Employee Signature:
Reimbursement Total:
$0.00
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Date Submitted:
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Principal/Supervisor Signature:
Funding Source (Required):
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(Finance office use only)
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Approved:
MUNIS Account Code:
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Review/Revised: 7/14/22
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