Domestic Voucher Expense Sheet
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:_________________________$________________