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
$

Travel Advance

Currency conversions will be calculated using the web site FXConverter and based on your travel departure date.

Date Description Amount Currency
$


Personal Vehicle Mileage
For travel within New Mexico, you must use UNM’s New Mexico Mileage Chart to determine your expensible mileage. For travel outside of New Mexico, you must use MapQuest. If you have in-state mileage to be reimbursed, please fill out the mileage report.
miles

Expenses

Do you have hotel expenses? yes no
Do you have airline expenses? yes no
Was there a conference/workshop/meeting fee? yes no
Were you a presenter at the conference/workshop/meeting? yes no
Was there a rental vehicle? yes no
Were there ground transportation expenses? yes no

Account Distribution

Index Code Index Description Acct Code/Description  Add Row 
Authorized Name

Additional Information
Please note any additional information including shared expenses or conference fees paid for by another source.

On the next page, please print this form as a .pdf and send it to pais@unm.edu, along with any receipts and agendas. We recommend you keep a copy for your records.