315x Filetype XLSX File size 0.03 MB Source: med.stanford.edu
BMI / BMIR Travel Reimbursement Summary
Instructions: After all travel is complete, fill out the expense summary below to request reimbursement. If you traveled to two or more locations to attend multiple conferences or
workshops, fill out a separate expense sheet for each event if you are using different accounts for reimbursement.
Name: Enter your name SU ID: University ID Date: Today's date
Email: Enter your email address Phone: Enter phone number
Conference Name: Enter full conference name, not the acronym Conference Dates: Date of conference
Business Purpose: Who, What, When, Where & Why you traveled for Stanford.
Check here if you used a Department Travel Card for any of these expenses. Indicate what was paid in the Notes Field below. Include the expenses on
your summary even though you are not being reimbursed for them so that your administrator can clear any advances or travel card expenses using
the receipts you provide.
If your travel was foreign, use the Oanda currency converter link to determine foreign currency equivalents. Calculate using the date you made the purchase. Print the result and submit with your receipts.
Fingate (Stanford’s Gateway to Financial ActiviStiteas)nford Admin Guide Travel Domestic Per Diem Rates M&IE Breakdown (domeFsotirc)eign Per Diem RatesM&IE Breakdown (use for foreign traveOl)anda Currency Converter
Actual Meals Total
Travel Location /Airport Conference Lodging - Car Rental Parking & Other Per Diem Incidental Mileage Personal
Date Code Registration * Tutorials Airfare * Per Diem or * Tolls Transportation Meals ** Expenses (3/1/16 at Car Miles
Actual * (taxi, shuttle) Breakfast Lunch Dinner /Other Costs * 54¢)
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
Date of Expense $ - $ -
$ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ -
Enter the number of meals provided by others or included in Notes
the registration ** Indicate if you are not requesting reimbursement for all itemized expenses above in the Notes section. $ - $ -
Meal Number Date Range Type here Subtotal $ -
Breakfast Advance
Lunch Total $ -
Dinner
Type explanations for other costs and incidentals here, as well as justifications for the expenses.
Comments or
Justifications
List source(s) of support by name PTA/ Account number Total $ amount or % support
1) source or fund name Enter Project- Task- Award Allocation
2) source or fund name Enter Project- Task- Award Allocation
3) source or fund name Enter Project- Task- Award Allocation
*There is no need to separate lump sum fees, i.e., airfare, lodging, into days. See the comment attached to the Date cell for instructions.
** Use the M&IE site to determine deductions if meals were included in conference registration fees.
After completing the form, save it as an Excel spreadsheet , print it and submit with all receipts and required forms.
travel_expense_reimbursement_summary.xlsx 08/09/2022
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