Faculty Handbook

Travel Authorization Form

(1) T.A. No.
(2) Original ( ) Revised ( )
(3) Requested Date
  1. Use this form to obtain approval for all out of state travel and in-state trips involving any non-milage expense greater than $25.00 per trip.
  2. Type and get authorized signature(s) then forward it with substantiating documentation to the Office of Administrative Services.
  3. If Personal car will be used; a current copy of the car insurance policy must be on file.
(4) Employee Name (5) Home Phone (6) Banner ID
(7) Title (8) Work Phone (9) Employee #
(10) Official Duty Station: 181 White Street Danbury, CT 06810 E-Mail Address
(11) Collective Bargaining Unit ( ) AAUP ( ) MGMT ( ) SUOAF-AFSCME ( ) Other
Itinerary
Depart
Return
Carrier Info
(12) Home/Duty Station (13) Travel To (14) Date Hour (15)Date Hour (16) Flight/Rail/Bus
             
(17) Object and Necessity of Travel (Attach substaining documents)
(18) Type Of Transportation
Air ( ) Central Reservations
Rail ( ) Central Reservations

( ) Parking Permit Bradley
( ) Outside Agency
( ) Outside Agency

Airport Only
( ) Personally Owned Car
( ) State Owned Car

Names of Riders:
Car Policy Exp. Date
(19) Reg. Prepaid by Agency ( ) Yes
( ) Yes		 (20) Vendor's FEIN# (MANDATORY) _____________________
(22) Amount Requested: $______________________________
Total Cost (Itemize) Note: Rates for meals and lodging should not exceed those provided for in standard travel regulations and in collective bargaining agreements.
(23) Airfare/Rail _______ (29) Lodging
(Per Diem Rate) $
_______
(24) Registration _______ (30) Conference Hotel
_______
(25) Rental Car _______ (31) Hotel Tax
_______
(26) Taxi/Limo _______ (32) Meals
(Per Diem Rate) $
 _______
(27) Parking/Toll _______ (33) Personal Milage
Miles @ 50.5 cents
 _______
(28) Other (specify)  
TOTAL COST
 _______
(34) Banner Org (35) Account (36) Amount Auth. Signature Banner Org. Account Amount & Auth. Signature
               
               
               
(37) AUTHORIZED SIGNATURES
Employee Signature   Date:
Approved by: (Supervisor)   Date:
Approved by: (Dean/Dir.)   Date:
Authorized by (President/VP)   Date:

 


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