Travel Reimbursement Request

Travel Reimbursement Request

Boulder Town, Utah
Utah's 2026 state travel reimbursement policy aligns closely with federal GSA guidelines.

Key reimbursement rates are as follows:
- Lodging: Commercial lodging (hotels or vacation rentals) is reimbursed up to $110 per night and requires receipts. A $25.00 per night allowance is available for non-commercial stays (with friends/family), subject to advance town council approval.
- Meals & Incidentals (M&IE): The standard daily allowance is $68. This rate is reduced to $51 (75% of the standard rate) for the first and last days of travel. A day trip lasting over 12 hours without an overnight stay may also be reimbursed at the $51 rate.
- Mileage: Personal automobile mileage is reimbursed at a standard rate of $0.725 per mile. Motorcycle mileage is reimbursed at $0.705 per mile.
Reimbursement for any travel expenses requires approval from the governing body responsible for the budget area from which the funds will be allocated. If there is any uncertainty regarding the approval process, always seek clarification and follow up directly with the Mayor.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Governing Body
Planning Commission, Staff, Etc
Position/Title
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purpose of Travel*
Please provide the purpose or reason for your reimbursement request, including as much detail as possible to ensure timely processing.
Departure Date

MonthDayYear
Date
Return Date

MonthDayYear
Date
Destination*
Name and Address
Approver/Supervisor
Who has/will approve the travel/reimbursement
- For overnight lodging, every effort should be made to secure the State contracted rate. Lodging reimbursement requires receipts and may be capped at $110 per night. If staying with family, friends, or elsewhere, a $25 per night rate may apply. Overnight stays are approved only for trips over 75 miles and/or spanning multiple days.
- Name of Motel/Hotel
- Address of Motel/Hotel
- Number of Nights Stayed
- Total Cost for All Nights
- TOTAL Lodging Reimbursement Amount ($) *
  Commercial lodging reimbursed up to $110 per night; $25 allowance for non-commercial stays with approval
- File Upload if applicable
  
  Cancelof
- The standard daily allowance for Meals & Incidentals (M&IE) is $68, broken down as $16 for breakfast, $17 for lunch, $30 for dinner, and $5 for incidentals. This daily rate is reduced to $51 (75% of the standard rate) for the first and last days of travel. A day trip lasting over 12 hours without an overnight stay may also be reimbursed at the $51 rate.
  
  Note that no reimbursement will be made for a meal if one was provided (e.g., continental breakfast, meals at an event), regardless of whether the employee ate it. To claim breakfast, an employee must leave before 7:00 AM. To claim dinner, an employee must return home after 7:00 PM. Alcoholic beverages are not eligible for reimbursement.
- How many BREAKFASTS should be reimbursed for this trip?*
  $16 per meal
- How many LUNCHES should be reimbursed for this trip?*
  $17 per meal
- How many DINNERS should be reimbursed for this trip?*
  $30 per meal
- How many INCIDENTALS should be reimbursed for this trip?*
  $5 per day
- TOTAL Meals & Incidentals (M&IE) Reimbursement Amount ($) *
  Standard daily allowance is $68; $51 for first and last days or day trips over 12 hours
- File Upload if applicable
  
  Cancelof
- Carpooling is strongly encouraged when employees attend the same event.
  
  Effective January 1, 2026, the following mileage reimbursement rates apply:
  - Personal Automobile: $0.725 per mile
  - Motorcycle: $0.705 per mile
- Starting/Ending Location
- Destination Location
- Total Mileage
  If the starting and ending odometer readings were not logged, use an online map or app with the trip's starting and ending addresses to calculate the mileage
- Rate Per Mile ($)
  Personal vehicle mileage reimbursement rates are $0.725/mile for cars and $0.705/mile for motorcycles.
- TOTAL Mileage Reimbursement Amount ($)*
- File Upload if applicable
  
  Cancelof
- Registration Fee ($)
  receipts required
- Parking Fees ($)
  receipts required
- Other Fee ($)
  receipts required
- Please describe other fees:
  receipts required
- TOTAL Other Expenses ($) *
- File Upload if applicable
  
  Cancelof
- TOTAL Reimbursement Request*
  The total reimbursement amount is derived from the sum of expenses for lodging, M&IE (Meals & Incidental Expenses), mileage, and other miscellaneous items.
- Specify the Budget Code/Line Item for this travel.*
  If you do not know the exact budget code or line item/department, please provide the best possible description (e.g., Fire Department or PC Training). Alternatively, contact the Mayor, Chair, or Clerk to obtain the necessary information for completion before submitting.
- I, Full Name certify, to the best of my knowledge, that all information contained in this request and its attachments is true and correct. I affirm that this claim represents a legally approved obligation, and no portion of it has been previously paid to me.
- Signature*
  
  Powered by Jotform SignClear
- Date
  
  MonthDayYear
  Date
Should be Empty: