THE UNIVERSITY OF RHODE ISLAND, KINGSTON, RI 02881

CANDIDATE'S TRAVEL EXPENSE FORM

OUT-OF-POCKET EXPENSE ACCOUNT

Interviewing Department __________________________ LOG# _________________

Date(s) Interviewed ______________________________________________________

Name of Candidate _______________________________________________________

HOME Address __________________________________________________________

________________________________________________________________________

________________________________________________________________________

Social Security Number (needed for W-9) ____________________________________

TRAVEL EXPENSES:

Auto - Miles _____ at ______per mile	$____________________
Currrent rate is $0.405 per mile]

Other Transportation (train, bus, etc.)	$____________________
[No rental vehicles permitted]

Taxi [Attach receipt(s)]

$____________________

Tolls [Attach receipt(s)]

$____________________

Meals [Attach itemized receipts]

$____________________

[FY2003 rates: Breakfast not to exceed $4 per person or a total of $8 (including tips). Lunch not to exceed $6 per person or a total of $18 (including tips). Dinner not to exceed $14 per person or a total of $42 (including tips).]

Miscellaneous Not to exceed $5 [Attach receipt(s)]

$____________________

TOTAL EXPENSES

$____________________

Signature of Candidate: _________________________________________________________________________________

Date

Authorized Search Committee Member: ____________________________________________________________________

Date

Approved Human Resource Administration: ________________________________________________________________

Date

Note: STATE OF RHODE ISLAND REGULATIONS PROHIBIT PAYMENT FOR ALCOHOL BEVERAGES.

Note: FOR ACCOUNTING PURPOSES, W-9 FORM MUST ACCOMPANY ANY OUT-OF-POCKET EXPENSE REQUEST.