Guest Reimbursement Form

Guest Reimbursement Form

Travel & Business Reimbursement Form
Guest Name:

First NameLast Name
E-mail
example@example.com
Phone Number
Permanent Address (should match address used for tax purposes)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Event Type
Event Date*

MonthDayYear
Date
Seminar Number and Name*
You can view a list of our seminars here: https://universityseminars.columbia.edu/seminars/
Have you received a reimbursement from Columbia University in the last six months?

YesNo
If you have not received a reimbursement from Columbia University in the last six months or if this is your first time requesting a reimbursement from Columbia, you will be invited to complete a PaymentWorks profile. Our administrative assistant (Giran Ceballos - grc2136@columbia.edu) will let you know when to expect an email from PaymentWorks. Please complete this form as soon as possible. Vendor profiles need to be approved by the University before we can proceed with any reimbursement request.

List of Expenses -

Subtotal Expenses
Calculated Field
For Mileage only, please provide a listing of starting point(s) and destination(s) addresses. We recommend you use Google Maps to confirm the total number of miles. Please note, the Concur system mileage amount may vary slightly from the amount calculated on this form.
Number of Miles (if applicable)
If applicable
Current Year Mileage Rate
$.655/miles for travel on or after January 1, 2023. $.670/miles for travel on or after January 1, 2024
Mileage Amount
Calculated Field
Total Amount Requested
Calculated Field
Please upload receipts and other supporting documentation
Supporting Documentation include email announcements, invitations, and/or event programs

For non-US residents, please upload a copy of Form I-94 or the passport page with the visa entry stamp as supporing documentation.
Upload Receipts

Cancelof
Upload Supporting Documentation

Cancelof
Additional Information
Please verify that you are human*
Should be Empty: