FORM TITLE:            Travel and Business Expense Report

PROCEDURE:           05-07-01

EFFECTIVE DATE:    July 1997

PAGE (S):                   2


1.   Date of report (MM/DD/YY).

2.   Full name of payee (Last, First, Middle Initial).

3.   Check appropriate box indicating whether or not the payee is a University employee.

4.   School or division affiliation.

5.   Social security number of the payee.

6.   Room number and name of building.

7.   Street address.

8.   City, State and Zip Code or Foreign Country.

9.   Purpose of payment.

10. Check appropriate box indicating whether or not tickets were charged to a University

      Certified Travel Agency.

11. Amount charged.

12. Account number charged.

13. Check appropriate box indicating whether expenses are to be shared with an outside


14. Name of organization sharing expenses; address of organization; and the amount

      the other organization will contribute.

15. Date expense incurred.

16. Destination of trip (from and to).

17. Amount of commercial transportation.

18. Amount of taxi or limousine.

19. Number of miles personal car was used.

20. Total amount for use of personal car (number of miles times current mileage rate

      per mile).

21. Amount for meals in travel.

22. Amount for other meals.

23. Amount for lodging.

24. Amount for telephone, TWX, FAX, etc.

25. Amount for miscellaneous expenditures (explain on back in space provided).

26. Total expense for date of detailed summary.

27. Account number(s) charged (maximum of 5 accounts).

28. Portion (in dollars) of each type of expense distributed to applicable account.

29. Total distributed to each account.

30. Totals by type of expense.

31. Signature of payee.

32. University telephone number or extension of payee.

33. Printed name of account administrator and University telephone number or extension.

34. Signature of account administrator.

35. Less advance received date and amount.

36. Amount due payee.

37. Amount due University.

Back of Form

38. Date of expense.

39. Place expense was incurred.

40. Name of persons attending and organization represented.  Provide social security

      number where applicable.

41. Indicate type of expense.

42. Amount of expense.

43. Explanation of expense.

44. Total expense.