Meal Per Diem Request Form

Overnight Travel

Notes:

Use of the per diem for alcoholic beverages is prohibited.
Incidental Expense allowance only applies to overnight travel. They are restricted to 75% ($3.75) on the first and last day of travel.
Per diem for a meal will not be issued if the meal is provided as a part of a meeting or conference registration, etc. being paid by the City.

Meals
Departure Date*
Full Day(s) of Travel
Return Date*
The City of Fort Dodge follows the federal meal per diem rates established by the General Services Administration (GSA). A complete list of states and destinations can be found at www.gsa.gov. Use this information to determine the total per diem owed to you.

An example of Meals & Incidentals rates & breakdown is below.
Per Diem Calculation
Breakfast M&IE Amount
(from gsa.gov)
Total Days with Breakfast
(from above)
Lunch M&IE Amount
(from gsa.gov)
Total Days with Lunch
(from above)
Dinner M&IE Amount
(from gsa.gov)
Total Days with Dinner
(from above)
Partial Incidental Expenses
Total Days of Partial Incidental Expenses
Incidental Expenses
Total Days of Full Incidental Expenses
(from above)
Payment Information
Total Per Diem Owed
G/L Account to Pay from*
Supporting Documentation*

Cancelof
Authorization
Manager's Email for Final Approval
example@example.com
Should be Empty:

City of Fort Dodge Travel Policy - Meals