<p> FY2017 CBE POST-TRIP WORKSHEET Travel Name Email T Number Departure City/ST Destination City/ST Departure Date am Return Date am Time Time m/d/yy pm m/d/yy pm Destination #2 </p><p>Departure Date am Return Date am Time Time m/d/yy pm m/d/yy pm LIST REIMBURSABLE EXPENSES BELOW Airfare/Rail (list each purchase separately) $ $ $ TOTAL $ (itemized receipt that shows method of payment; flight itinerary to verify travel and departure/return times, even when a 3rd party pays) Lodging/Hotel $ Registration Rental Car $ (itemized receipt showing method of (itemized receipt showing method of (itemized paid receipt, copy of rental payment/how the transaction was settled. payment; conference schedule or contract. For non-contract vendors, LDW List internet and parking as misc. expenses) itinerary needed to claim meals) and CDW must be purchased) Gas (rental cars) $ or Mileage for personal vehicle miles driven x $.535 $ = (original itemized receipts required) (print directions to show distance or keep a log with odometer readings for each trip leg) MISCELLANEOUS EXPENSES MEALS Provide a receipt for any miscellaneous expense over $50/incident List dates, then check boxes or enter exact dollar amounts Reimbursement of membership dues should be entered in eRequest (this expense is Per Diem $ /day (check boxes, enter daily total) disallowed on most research grants) Actual cost of meals (not to exceed per diem, enter dollar Tips to hotel/airport staff are incidental expenses covered by per diem amount) BREAKFAST LUNCH DINNER DATE EXPENSE TYPE BUSINESS PURPOSE AMOUNT DATE TOTAL 25% 25% 50% $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Miscellaneous Expenses Total $ Meal Total $ $ See https://osutravel.osu.edu for per diem rates and the currency conversion tool. Please note transportation or hotel expenses covered by a third party or another traveler. List the name and T# of OSU travelers who paid for your lodging or transportation. ADDITIONAL INFORMATION: </p><p>Amount to Reimburse $ 1.1.17</p>