Student Travel Reimbursement Request Form
Team Name:
*
Please enter your TEAM NAME here.
Name:
*
First Name
Last Name
Student ID # OR PERSON NUMBER:
*
Supplier Number:
Please enter your iO supplier number if you have one. If don't have one, we will be requesting this for you in order to process your reimbursement.
Email:
example@example.com
Do you have Direct Deposit with Rice? (Direct deposit is preferred. You may sign up for Direct Deposit through your iO Account.) PLEASE MAKE SURE TO UPDATE ALL YOUR INFORMATION IN YOUR IO ACCOUNT, AS THAT IS THE INFORMATION THAT WILL BE USED FOR YOUR PAYMENT PROCESSING.
Yes
No
Travel Purpose:
*
Names of all Travelers:
*
Location - Departure City and Return City:
*
Travel Start Date:
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-
Month
-
Day
Year
Date
Travel End Date:
*
-
Month
-
Day
Year
Date
OUT OF POCKET TRAVEL
You must include the Transaction Dates, Vendors, Description of Expenses (lodging, airfare, ground transportation, etc.) and total for each receipt in an Excel spreadsheet. These expenses must match your receipts. You will NOT be reimbursed for any taxes paid.
Attach your spreadsheet of expenses here:
*
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Total to be reimbursed (including mileage):
*
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RECEIPTS
Attach original, itemized, paid receipts as pdf files. Group by type and name as follows: Registration.pdf Airfare.pdf Lodging.pdf Transportation.pdf Meals.pdf Miscellaneous.pdf BackUP.pdf -You may combine mulitple receipts into 1 file, but please DO NOT EXCEED 6 receipts per PDF file. Any sales tax paid will NOT be reimbursed.
Add your receipts(s) here:
*
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Mileage Reimbursment - please provide addresses of all stops and total miles to be reimbursed. We will use google maps to determine the final number of miles to be reimbursed based on stops:
Attach Travel Back Up Documentation here:
*
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Back up documentation can be anything that provides proof of the event or competition such as event details from their website or an email.
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Comments:
Please mention if any awards were won:
Submit
Should be Empty: