Travel Order Number: _____________________Traveler: ____________________
Area Contact: ____________________________Phone Number: _______________

Departed from (circle one): home, office, other: __________________________

Time and date left trip:___________________________ a.m. or p.m.
Time and date returned to residence or work:____________________________a.m. or p.m.

Annual Leave Dates (if applicable): _____________________________________________
__________________________________________________________________________

Primary Transportation (circle one) POV Rental Car Train Plane
Cost (attached receipts): $_____________________ GTR#: _______________

Departure Date:__________Time: ___________a.m./p.m. City/State:_______________________
Arrival Date:____________Time: ___________a.m./p.m. City/State:_______________________

Departure Date:__________Time: ___________a.m./p.m. City/State:_______________________
Arrival Date:____________Time: ___________a.m./p.m. City/State:_______________________

Departure Date:__________Time: ___________a.m./p.m. City/State:_______________________
Arrival Date:____________Time: ___________a.m./p.m. City/State:_______________________
POV Mileage Round-trip:________________ @ $.31 per mile = $________________

Taxis Taken (need receipts for over $25):

Date:_________________ From:_________________ To:_________________ $_______
Date:_________________ From:_________________ To:_________________ $_______
Date:_________________ From:_________________ To:_________________ $_______
Date:_________________ From:_________________ To:_________________ $_______
Date:_________________ From:_________________ To:_________________ $_______

Tolls (attach receipts):

Date:____________________ Where:______________________________________$_______
Date:____________________ Where:______________________________________$_______
Date:____________________ Where:______________________________________$_______
Date:____________________ Where:______________________________________$_______

Parking (attach receipts):

Date:___________________ Where:_________________________$______________
Date:___________________ Where:_________________________$______________
Date:___________________ Where:_________________________$______________
Date:___________________ Where:_________________________$______________

Personal Phone Calls (attach receipts), must be authorized on travel order.

Date:____________________________ Date:____________ $________________
Date:____________________________ Date:____________ $________________
Date:____________________________ Date:____________ $________________
Date:____________________________ Date:____________ $________________
Date:____________________________ Date:____________ $________________

Business Phone Calls (attach receipts), must be authorized on travel order.

Date:__________________________ Date:_____________ $________________
Date:__________________________ Date:_____________ $________________
Date:__________________________ Date:_____________ $________________
Date:__________________________ Date:_____________ $________________
Date:__________________________ Date:_____________ $________________

Lodging (attach receipts):

Number of nights at government expense: ________________________________________

Cost per night (include all taxes paid): $____________ X ________(no. of nights) $_______

Attach receipts for meals only if AEA (memo must be approved prior to departure date for AEA).

Miscellaneous Cost (attach receipts) (photocopying, faxing, shipping, etc.):
Justification/explanation needed if amount was not estimated under additional expenses on travel order.

Date:___________________ Specify:_________________________$________________
Date:___________________ Specify:_________________________$________________
Date:___________________ Specify:_________________________$________________
Date:___________________ Specify:_________________________$________________