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Travel Request Form

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General and Traveler Information

*Traveler's Email Address:  

*Traveler's Last Name:                 *Traveler's First Name:       *Traveler's Job Title:

*Traveler's Work Phone No.:                        *College Dept.:          *Traveler's PS No.:

*Traveler's Cell Phone No.:  

*Purpose and Benefit of Travel:

Name of Conference or Event:

Website address for Conference or Event:

If you are presenting a paper please list the title:

*Are you scheduled to teach during travel?   Yes No

Classification of Traveler (Select one)

*Classification of Traveler

Itinerary

*Departure City/State/Country: *Destination City/State/Country:

*Departure Date: *Return Date:

*Rental Car Company (N/A if not renting): *Hotel Name or Type "Private Residence":

*Will any days be spent on non-business activities, such as a personal day spent not attending a conference or meeting?   Yes No

Expenses

UH Meals and Lodging Rules: The following are daily maximum allowable rates for Meals and Lodging combined for UH travelers. If you are traveling under the university rate to Austin, TX, then maximum reimbursement for meals and lodging is $265. The per diem rate for meals is $61. If you find a hotel for $150 per night, you could be reimbursed up to $115, if you choose to turn in itemized receipts for food. If you choose not to turn in itemized receipts for food, then the maximum that you can be reimbursed for food is $61. The same logic applies to out-of-state travel. If you do not turn in receipts and wish to claim per diem, you must submit a statement stating your actual meal expenditures for each day and you will be reimbursed up to the per diem amount.

Overnight Travel Destination

Local Funds/University Rate

State Funds/Per Diem Rate

Texas

$265

See the GSA website for maximum*

Outside of Texas but within the Continental United States (Top 5 highest cost destinations: San Francisco, CA; Santa Monica, CA; Boston/Cambridge, MA; New York City, NY; Seattle, WA)

$410

See the GSA website for maximum*

Outside of Texas but within the Continental United States (All other destinations outside of the Top 5 highest cost destinations)

$330

See the GSA website for maximum*

Outside the Continental United States (lower 48 states)

$450

Higher of $350 or rate on the GSA website
(follow link to DOD website)*

UH travel policies and information on Per Diem and Mileage Reimbursement Rates are found at http://www.uh.edu/finance/pages/AP_Travel.htm.

List Estimated Travel Expenditures in dollars ($):

Please list the name of the account to be charged (department, grant, or other - please be specific):

Indicate % or amount of travel expenditures to be paid/reimbursed by non-UH third party (e.g., company): %:   Amt:

Name of non-UH third party:

*Would you like the College to make reservations and pre-pay your airfare, hotel, and/or registration?   Yes No

"Upon return of trip, please email COE Travel the following: airfare itinerary, hotel bill, taxi receipts, parking receipts. If you wish to be reimbursed the allowable per-diem for food, provided the per-diem for food plus the hotel bill does not exceed the UH cap, then no food receipts are required. If you wish to be reimbursed for actual meals, then itemized receipts are required."

Please print a copy for your records before you submit this form:

This information will also be sent to the email address you entered on the form.

 *I have reviewed and understand the above UH travel policies and information on meals, lodging, and mileage reimbursement rates.

*Please enter your initial:

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Click the SUBMIT button to finish.