Reimbursement of Travel

2017 REIMBURSEMENT OF TRAVEL ♦ Lakeview College of Nursing ♦ 903 North Logan Avenue ♦ Danville, Illinois 61832 ♦

DESTINATION/PURPOSE

LODGING Hotel/Motel ( Nights @ $ per night) $

MEALS (Must submit each itemized receipt. No alcoholic drinks reimbursed) Breakfast Days @ $7.00 $

Lunch Days @ $12.00 $

Dinner Days @ $20.00 $

(Prices shown are allotment per day/per meal. Example: if your breakfast costs $6.42; you only get reimbursed that specific amount…if your breakfast costs $8.20; you only get reimbursed the daily allotment of $7.00. Only 15% Gratuity will be reimbursed. Anything over allotment/gratuity will be the employee’s responsibility.)

TRANSPORTATION (must submit each itemized receipt) Air $ Airport parking $ Auto Miles @ $ .535 (IRS rate) $ Other (bus or train) $ Taxi $ Registration Fee (deduct any meals included from above meals allotment) $ Miscellaneous Reimbursement Expense (Itemize) $ $ $

TOTAL$

TOTAL AMOUNT ADVANCED $

AMOUNT RETURNED TO COLLEGE $

AMOUNT DUE TO EMPLOYEE FOR REIMBURSEMENT $

I hereby certify that to the best of my knowledge the information furnished on this form is true and complete and I have attached all itemized receipts. I understand that if found to be otherwise, it is sufficient cause for rejection of reimbursement.

Signed Date

This form must be returned no later than 5 business days after returning to LCN. Submit completed form and all itemized receipts to the Assistant to the President.

*Attach all required itemized receipts.

**Including Gratuities Effective 01.01.16