Pre- Authorization Support Staff Travel Voucher
Department of California (DAV) (HQ STAFF & EMPLOYEES)
Date of Request:
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Month
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Day
Year
Department Title
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Please Select
CEO
Director of Operations
Department HQ Staff
Department Support Staff (Events)
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Travel:
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Month
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Day
Year
Date
Date of Return:
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Month
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Day
Year
Date
Total Authorized Days of Travel (Days include travel and return dates)
$125.00 PER DAY IF STAYING OVERNIGHT AT LOCATION
Total Amount paid for Hotel:
Daily Per Diem Rate
Per Diem $125.00
Amount Per Diem Due:
Destination: (Location of Event)
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Purpose of Travel:
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Type of Travel Expenses: (Select all that apply during travel day)
Airfare
Vehicle (Rentals, Economy authorized only)
Shared Ride (Uber, Lyft, Economy Vehicles Authorized Only)
Meals (Not Covered by Per diem rate)
Registration Fees (If applicable)
Parking Fees
Other
Expenses: (DO NOT INCLUDE HOTEL)
(Example: parking fees, registration fees, etc)
Total Miles Traveled: (To and From Destination)
(Mileage per diem rate: $0.700 per mile)
Milage Per Diem Rate:
Total Miles Amount:
Attached Receipts for ALL personal expenditures: (Hotel, Rental, Registration Fees, Parking, Uber, Flights, $25.00 or more)
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Travel Authorization Disclaimer: All travel related to official duties must receive pre-authorization prior to departure and be formally approved by the Department of California. Approval is strictly limited to travel that aligns with the scope of responsibilities and duties associated with the roles of Line Officers, State Executive Committee members, Employees, and Designated Team Staff. Travel must be directly related to sanctioned events, official meetings, or functions that fall within the remit of your designated position. Personal vacations or any form of personal travel will not be authorized or reimbursed under any circumstances. Failure to obtain prior approval or undertaking travel for purposes outside of authorized duties may result in denial of reimbursement and could lead to disciplinary action.
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I agree to the terms
Signature of Officer:
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Total Amount Voucher (Pending Department Approval)
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