Travel Reimbursement Request Form

Please contact Todd at 645-1745 or tmnibbe@buffalo.edu if you have additional questions or concerns.

Personal Information

(Required)
(Required)
(Required)
(Required)
 
(Required)
Are you
Are you
(Required)
 
 
 
 
How are you normally paid?
How are you normally paid?
(Required)
 
 
(Required)
(Required)

Trip Information

(Required)
e.g 2018 Annual AIChE, 2016 Regional AIChE
(Required)
e.g. New York City, NY
(Required)
e.g. September 20, 2018 at 8:00AM
(Required)
e.g. December 3, 2019 at 3:20PM

Expenses to Be Reimbursed

For the sections below, please fill in the space that applicable to you. Please also note that a PDF version of your original receipts for every items requested in each catagory should be scan and upload along with the form. If you encounter problems with this step, please contact Todd Nibbe at Furnas 303 or at tmnibbe@buffalo.edu.

 
 
 
 
e.g. Hilton
 
e.g. $201.35
 
 
e.g. Delta, DE205
 
 
 
 
 
 
 
e.g. $23.65
 
 
 
e.g. Hertz
 
 
 
 
 
(Required)

*For meal reimbursement, a hotel bill with a $0 balance is required. Even if you didn’t pay for it. For rental cars, a written statement of why you rented instead of taking a cab is required. If expenses were shared, please turn in reimbursement requests together. Reimbursements will not be made until all persons have requested reimbursement. - please note which expenses were shared.

State travel must be booked through CTA-see a secretary for details.