Travel Authorization

Authorization Number

Assigned by the appropriate office.

Employee name

First Name, Middle Initial, Last Name

Agency guidelines may specify the order, e.g., last name first.

Employee Identification

Employee Number

Must use a number, e.g., SSN, vendor number, or other number that identifies the employee.

Travel Purpose Identifier

Site visit

Information meeting

Training attendance

Speech or presentation

Conference attendance

Relocation

Same as change of official station.

Entitlement travel

Travel Period

Start Date, End Date

Month, Day, Year according to agency guidelines.

Travel Type

CONUS/Domestic

Travel within continental United States.

OCONUS/Domestic

Travel outside continental United States.

Foreign

Travel to other countries.

Leave Indicator

Annual, Sick, Other

Identifies leave type as the reason for an interruption of per diem entitlement.

Official Duty Station

City, State, Zip

Either the corporate limits of city/town or the reservation, station, established area where stationed.

Residence

City, State, Zip

The geographical location where employee resides, if different from official duty station.

Payment Method

EFP

Direct deposit via electronic funds transfer.

Treasury Check

Imprest Fund

Mailing Address

Street Address, City, State, Zip

The location designated by the traveler based on agency guidelines.

Transportation Payment

Method employee used to purchase transportation tickets.

Method Indicator

GTR

U.S. Government Transportation Request.

Central Billing Account

A Contractor centrally billed account.

Government Charge Card

In accordance with and as provided by agency guidelines.

Cash

Transportation Payment Identification Number

Payment ID Number

A number that identifies the payment for the transportation tickets, according to agency guidelines, e.g., GTR number, Govt. contractor-issued charge card number.

Transportation Method Indicator

Air (First-class and business-class)

Air (Non-first-class and Non-business-class)

Non-contract Air, Train, Other

Common carrier used as transportation to TDY location.

Local Transportation Indicator

POV, Car rental, Taxi, Other

Identifies local transportation used while on TDY.

Per Diem

Total Number of Days

The number of days traveler claims to be on per diem status, for each official travel location.

Total Amount Claimed

The amount of money traveler claims as per diem expense.

Lodging, Meals & Incidentals

Travel Advance

Advance Outstanding

The amount of travel advance outstanding, when the employee files the travel claim.

Remaining Balance

The amount of the travel advance that remains outstanding.

Subsistence

Actual Days

Total number of days the employee charged actual subsistence expenses.

The number of days must be expressed as a whole number.

Total Actual Amount

Total amount of actual subsistence expenses claimed as authorized. Actual subsistence rate, per day, may not exceed the maximum subsistence expense rate established for official travel by the Federal Travel Regulation.

Transportation Method Cost

Air (First-class and business-class)

The amount of money the transportation actually cost the traveler, entered according to method of transportation.

Air (Non-first-class and Non-business-class) Non-contract Air, Train

Bus or other form of transportation.

Other

Local Transportation

POV mileage

Total number of miles driven in POV.

POV mileage expense

Total amount claimed as authorized based on mileage rate. Different mileage rates apply based on type and use of the POV.

Car rental, Taxis, Other

Constructive cost

Constructive cost

The difference between the amount authorized to spend versus the amount claimed.

Reclaim

Reclaim amount

An amount of money previously denied as reimbursement for which additional justification is now provided.

Total Claim

Total claim

The sum of the amount of money claimed for per diem, actual subsistence, mileage, transportation method cost, and other expenses.

Accounting Classification

Accounting code

Agency accounting code.

Non-Federal Source Indicator

Per Diem, Subsistence, Transportation

Indicates the type of travel expense(s) paid, in part or totally, by a non-Federal source.

Non-Federal Source Payment Method

Check, EFT, Payment “in-kind”

Total payment provided by non-Federal source according to method of payment.

Signature/Date Fields

Claimant Signature

Traveler’s signature, or digital representation. The signature signifies the traveler read the “fraudulent claim/responsibility” statement.

Date

Date traveler signed “fraudulent claim/responsibility” statement.

Claimant Signature

Traveler’s signature, or digital representation. The signature signifies the traveler read the “Privacy Act” statement.

Date

Date traveler signed “Privacy Act” statement.

Approving Officer Signature

Approving Officer’s signature, or digital representation. The signature signifies the travel claim is approved for payment based on authorized travel.

Date

Date Approving Officer approved and signed the travel claim.

Certifying Officer Signature

Certifying Officer’s signature, or digital representation. The signature signifies the travel claim is certified correct and proper for payment.

Date

Date Certifying Officer signed the travel claim.