Application for Travel Reimbursement

Application for Travel Reimbursement

Questions? Email reimbursements@ntswim.org
Applicant Type*
(Required)
Email (parent/guardian email if under 18)*
example@example.com
Applicant Name (as registered with USA Swimming)*

First NameMiddle NameLast Name
USA Swimming ID*
(Required)
Team Name*
(Required)
Application Date*

MonthDayYear
Today's Date
Travel Meet Season, Name & Date
Travel Meet Name, Location, Date & Season*
Note that not all meets are reimbursable (see P&P Section 1500 Travel Funds). If the meet you are looking for is not in this list it may not be an eligible meet or it may be more than 30 days past the end date of the meet and therefore ineligible for reimbursement.

For any questions or for assistance on meets eligible for reimbursement, please contact reimbursements@ntswim.org.

Travel Information for your trip to:

{travelMeet}

For any questions or for assistance, please contact reimbursements@ntswim.org.
Travel Start Date*

MonthDayYear
Enter the first day of travel being reimbursed: the day the applicant departed for the eligible competition
Travel End Date*

MonthDayYear
Enter the last day of travel being reimbursed: the day the applicant returned from the eligible competition
Travel to Eligible Competition will be reimbursed using one of the following methods:
- Mileage: NTSI will use the current mileage reimbursement rates established by the IRS each year. NTSI will calculate the roundtrip mileage from Dallas city center to the city center of the host city and the mileage reimbursement request will be limited to one claim per vehicle used.
- Airfare cost: NTSI will determine the roundtrip airfare cost to be reimbursed based on the location of the Eligible Competition using GSA Rates.
- Rental Vehicle: NTSI will reimburse a standard rental vehicle or equivalent along with applicable fees, taxes and gasoline for a number of day’s rental corresponding to the number of days used for reimbursement of per diem expenses.
Travel Method*

Personal Car (Mileage, only permitted for distances under 500 miles)AirRental VehicleN/A, Did not incur my own travel cost (eg. rode with someone else, used miles to buy air ticket, etc.)
Airfare*
Actual Mileage*
Mileage from the center of Dallas, TX to Meet City (only allowed for distances of under 500 miles total)
IRS Mileage Rate*
Mileage Total
Rental Vehicle and Fuel Expenses*
Enter your actual expenses (receipts required) for a Standard rental car or equivalent, taxes, fees and fuel.
Rental and Fuel Amount*
Rental and fuel amount is actual expenses submitted per P&P.
Lodging: North Texas Swimming, Inc. will use the Double Occupancy (see P&P 1502 Travel Policy Definitions and Applicability) lodging rate for reimbursement of lodging expenses. Lodging nights will be based upon the number of nights {lodgingWording}
Lodging Wording
Lodging?*

Paid for a hotel (must provide hotel receipt)Paid for a hotel with Loyalty PointsSomeone else paid for my hotel, or I stayed with family / friends
Nights Lodging*
Determined from your Travel Start and Travel End Dates and is not editable.
Paid per night at Net Lodging Rate*
Rate is the double occupancy GSA rate (+15% tax) for meet location and is not editable.
Lodging Total
Meals and Incidentals: North Texas Swimming, Inc. will use Per Diem (see P&P 1502 Travel Policy Definitions and Applicability) reimbursement of Meals and Incidentals. The per diem will be based upon the number of days up to {lodgingWording}
Per Diem Wording
Days Meals and Incidentals*
Determined from your Travel Start and Travel End Dates and is not editable.
Paid per day at Per Diem Rate*
Rate is GSA per diem rate for the meet location and is not editable.
Meals and Incidentals Total
Receipts and Documentation

In order for your application to be considered for approval, you must submit a receipt for all the following based upon the answers provided above (see P&P 1502 Travel Policy Definitions and Applicability):

{travelMethod}

{lodging}

Any missing receipts and documentation may delay or prevent approval of this reimbursement application.

Note: It is not necessary to submit additional documentation to substantiate payment of the Meals and Incidentals / Per Diem or Personal Car Mileage.
Please upload receipts as requested above*

Upload file(s) in PDF or Image format as requested above.
Cancelof

1503 ATHLETE TRAVEL REIMBURSEMENT

2. Eligibility Requirements

To be eligible for NTSI travel reimbursement funds:
1. The athlete (and athlete’s club, where attached) must be registered in good standing with NTSI, compete in the Eligible Competition and meet all of the following criteria:
2. The athlete must compete with their NTSI registered club affiliation as their primary representation.
3. In the twelve (12) months prior to the start of the Eligible Competition, the athlete must have competed in at least six (6) meets, two (2) of which must be NTSI sanctioned meets, representing a North Texas Swimming member club team.
4. Relay-only athletes, having met the eligibility requirements listed above, are eligible to be reimbursed at a level of 50% of individual event participants.
5. The athlete must compete in all the events registered unless unable to do so because of circumstances beyond their control. In the event the athlete does not compete at the meet, the reimbursement will be evaluated on a case-by-case basis.
3. Additional Requirements

The athlete may be reimbursed up to two (2) Eligible Competitions per calendar year. In USA Olympic Trial years, athletes that compete in Olympic Trials may be reimbursed for Olympic Trials in addition to their two Eligible Competitions.
The athlete (or their parents) must attest to the fact they have not received any reimbursement from other sources.

The athlete or their parents must submit a travel reimbursement application within 30 days of the conclusion of the Eligible Competition. The form must be completed fully in accordance with the form instructions and must be accompanied by Receipts and Documentation (see 1502 Travel Policy Definitions and Applicability).
1504 COACH TRAVEL REIMBURSEMENT

2. Eligibility Requirements

To be eligible for NTSI travel reimbursement funds:
1. The coach (and coach’s club, where attached) must be in good standing and have one or more athletes competing in the Eligible Competition.
2. Additionally, athlete(s) under the direction of the coach must meet all of the following criteria:
3. Have competed in individual and/or relay events attached to the same club as the coach (or both are similarly unattached).
4. Be themselves eligible for Travel Reimbursement.
5. Compete in all the events registered unless unable to do so because of circumstances beyond their control. In the event their athlete(s) do not compete at the meet, the coach Travel Reimbursement will be evaluated on a case by case basis.
3. Additional REQUIREMENTS

Reimbursement for coaches is limited to a maximum of three (3) per team per Eligible Competition. Coaches must be noted on a team’s OME entry report to be eligible for reimbursement. Coaches must attest to the fact they have not received reimbursement from other sources.

Coaches must submit a travel reimbursement application within thirty (30) days of the conclusion of the Eligible Competition. The form must be completed fully in accordance with the form instructions and must be accompanied by Receipts and Documentation (see 1502 Travel Policy Definitions and Applicability).
1505 MEET OFFICIAL TRAVEL REIMBURSEMENT

2. ELIGIBILITY REQUIREMENTS

To be eligible for NTSI travel reimbursement funds, the Official must be registered in good standing with NTSI, and meet all of the following criteria:
1. The official (and official’s club, where attached) must be in good standing.
2. The official must have worked in at least ten (10) meets sanctioned by North Texas Swimming, Inc. during the twenty-four (24) months prior to the start of the Eligible Competition
3. Must work all sessions of the Eligible Competition unless unable to do so because of circumstances beyond their control. In the event the official does not work all sessions of the meet, payment of the Travel Reimbursement will be evaluated on a case-by-case basis.
3. ADDITIONAL REQUIREMENTS

An official may be reimbursed for up to two (2) Eligible Competitions per calendar year. In USA Olympic Trial years, officials that work at Olympic Trials may be reimbursed for Olympic Trials plus one additional Eligible Competition. Officials must attest to the fact they have not received reimbursement from other sources.

Officials must submit a Travel Reimbursement Application form within thirty (30) days of the conclusion of the Eligible Competition. The form must be completed fully in accordance with the form instructions and will be paid from North Texas Swimming directly to the individual applying.
CONFIRM ELIGIBILITY*

By checking this box, I confirm that all the information I have provided to North Texas Swimming is accurate, complete and that I am in receipt of the eligibility requirements as listed above and the applicant does qualify under those requirements. I attest to not having received any reimbursement from other sources. I also confirm that I understand the final determination on the eligibility of each application according to Section 1500 - Travel Funds rests with North Texas Swimming.
Applicant Signature (Parent/Guardian if applicant is under 18)*

Clear

SUMMARY AND ESTIMATE OF REIMBURSEMENT

Member:	{applicantName}
Meet:	{travelMeet}

Arrival:	{travelStart}
Departure:	{travelEnd}

Travel Days:

{daysPerDiem}

x Per Diem Rate

${netPerDiem}

= M&I Total

${mealsAnd}

Estimated Total Reimbursement*
NCSA Max Reimbursement*
Pro Series Max Reimbursement*
OW Jr/Sr Nationals Max Reimbursement*
Futures Max Reimbursement*
Winter Nationals Max Reimbursement*
Summer Nationals Max Reimbursement*
Olympic Trials Max Reimbursement*

Estimated Total Reimbursement:

${estimatedTotal}

*** Reimbursement Caps ***

● NCSA Spring/Summer Champs $800
● Open Water Jr/Sr Nationals $600
● Futures $800
● Winter Junior Nationals / US Open $900
● Summer Jr/Sr Nationals $1,100

This summary is based upon the information you provided in the application and is only an estimate. The final amount of and eligibility for reimbursement will be determined by North Texas Swimming.
Payee Name & Address*

Payee Name

Address (including Apt/Unit if applicable)

CityState

Zip Code
Payee Phone Number*
Please enter a valid phone number.
Payee Email*
example@example.com
Should be Empty:

Application for Travel Reimbursement

Travel Information for your trip to:

{travelMeet}

Receipts and Documentation

{travelMethod}

{lodging}

1503 ATHLETE TRAVEL REIMBURSEMENT

2. Eligibility Requirements

3. Additional Requirements

1504 COACH TRAVEL REIMBURSEMENT

2. Eligibility Requirements

3. Additional REQUIREMENTS

1505 MEET OFFICIAL TRAVEL REIMBURSEMENT

2. ELIGIBILITY REQUIREMENTS

3. ADDITIONAL REQUIREMENTS

SUMMARY AND ESTIMATE OF REIMBURSEMENT

{applicantName}

{travelMeet}