Travel Reimbursement Request

Form Revised: 08-11-2022

Use the following form to create a request for reimbursement of travel expenses. When you submit the form, a print-friendly version of your information will be displayed. Print two copies, one for your records and one to return to the front office, along with the original receipts.

Please Note: ALL receipts must be originals and they must show the form of payment and the balance as paid in full. If you are missing any of your original receipts, you must follow the Procedures for Lost or Missing Receipts.

Contact Information

Traveler Name

Email Address

Check all that apply
UNM Employee
UNM Student
Foreign National

How do you wish to receive your reimbursement?
Direct Deposit
Check

Destination, Purpose & Dates of Travel

Destination

University Business or Research Purpose (Include where, when, how UNM/grant benefits)

IMPORTANT: If this was a conference, workshop, or a meeting please attach something that references the meetings and makes reference to the research/grant. ( Agenda, e-mail, invitations.)

Departure
Date: Time:

Return
Date: Time:

Did you arrive 2 or more days prior to the conference/workshop/meeting or depart 2 or more days after the conference/workshop/meeting? yes no
Were any of these dates for personal travel? yes no

Meal Per Diem

Per diems will be calculated based on the U.S. State Department’s foreign per diem rates or the U.S. General Services Administration’s domestic per diem rates unless you indicate below that your rate is capped by the PI.

Per diem capped by PI?
No
Yes

Per diem cap
Required if you answered “Yes” above
$