ࡱ; B  !"#$%&'()*+,-./0123456789:;<=>?@AEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry  \pCalc Ba=@=@ 8X"1Arial1Arial1Arial1Arial1Arial1 Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1xArial1(x Arial Narrow1Arial1xArial1( Arial Narrow1Arial1Arial1Arial1Arial1Arial GENERAL MM/DD/YY M/D/YY #,###.00@ \$#,##0.00\ ;"($"#,##0.00\)0+" $"#,##0.00\ ;" $("#,##0.00\);" $-"#\ ;@\  M/D/YYYY#\$#,##0.00\ ;"($"#,##0.00\);"" #,##0,'#,##0.000\ ;" ("#,##0.000\);" -"#\ ;@\ 2-" $"#,##0.000\ ;" $("#,##0.000\);" $-"#\ ;@\                 + )  *        #  L H H#    # "" #X !X!  "  # "! "!   !  !   !  !     (w  hpw !  "  "  "  !  "   " "  !       " "         !  !  !  ! !   !  " " "             "  "  "!     "!   ""   "              !"!  "     !   !  "                 "        !!  !   !"!  "   Q  Q  !"!Q  "Q   Q  ! Q  #%  ! %  !"!%  "%    !     !  !  !            #  !  "   "                  "  (          !                 "  !  "  "  "  "  "  #  !          !   ! ""         !  !  !  !  "  "  !    !  "  "    !          !          `, WorkSheet9 PrintThisiSupplementary SheetzSuppSheetInstrrj03  @@   WORKSHEETUS $ Transactions Date Filed:XINSTRUCTIONS: Enter expenses on this sheet and results will appear on sheet PrintThis. MV"Items colored yellow are required.Pale Blue items are optional.=Please attach all receipts taped to 8.5 x 11 sheets of paper.Name: ??? Empl Id #: ??? Destination: Wherever Purpose: Whatever Start Date: End Date: Account to be Charged: ??? NSF GrantDate1. Airplane Fare2. Railroad Fare 3. Public Ground Transportation4. a. Private Auto Mileage* b. University-Owned Vehicle c. Rental Vehicle$ d. Other (Tolls, Parking, etc.)RELATED TRAVEL EXPENSE5. Hotel/Motel Room & Tax6. Breakfast (incl. Tax & Tip)7. Lunch (incl. Tax & Tip)8. Dinner (incl. Tax & Tip)9. Phone & Communications10.Tips (Other Than Meals)11. Meeting Registration Fees12. Per Diem**13. Additional Business Expense14. Other (Detail Below)" Forwarded Total from other sheetsSunMonTueWedThurFriSat$Accounts Payable Department Use Only* NORTHWESTERN UNIVERSITY"PV No.____________________________& TRAVEL EXPENSE REPORTPAYMENT REQUEST NO.#Vendor No._________________________NORTHWESTERN EMPL ID#FUNDAREAORG SUB ORGOBJECTSUB OBJAMOUNTSCHOOL/DEPT: WCAS MathematicsFROM:TO:PAID DIRECT BY OTHER PR'SSUNMONTUEWEDTHURFRISAT(LESS)NET TOTALPR#PR. AMT TOTALTRANSPORTATION COSTS 13. Additional Business Expense*Total this page*Forwarded from following pages TOTAL EXPENSE!Funds advanced by PR (Cash/Check) CERTIFICATIONAPPROVAL%Balance due to or from the UniversityI certify that I have paid out these amounts for University-related activities in support of the business purpose listed and in accordance with University policies and procedures, that sponsored project expenses contain no charges for alcoholic beverages or other unallowable items, and that I have not previously received nor will I receive separate reimbursement from Northwestern University or any other entity for any charge I am submitting on this form.I certify that these expenses were incurred for University-related activities and approve them as proper charges to University accounts.Traveler SignatureDean or Supervisor Signature John Franks Print Name44.a.* Complete Private Automobile Mileage Section.%12.** Extended Foreign Travel Only.rev. 01/23/08 See instructions on next page and http://www.northwestern.edu/finsys/polcydoc/travelmenu.htm for Travel Policies and Procedures -13.* Additional Business Expenses Section.SUPPLEMENTAL INFORMATIONInstructions on Following SheetPRIVATE AUTOMOBILE MILEAGE% TravelFill inFromTo Mileage X Current =TotalRate>Total all days (enter here and on front of Form -- line 4.a.). ADDITIONAL BUSINESS EXPENSESBAccording to I.R.S. Regulations -- you must provide the following:Date:Amount: Name of placeLocationBusiness PurposefThe occupation, or other information relative to the person or persons hosted, including name, title, +sufficient to establish relationship to you7Total all expenses (enter on front of Form -- line 13.) rev. 10/04' SUPPLEMENTARY SHEET INSTRUCTIONS (Detailed information is included in the Travel Policies and Procedures at http://www.northwestern.edu/finsys/polcydoc/travelmenu.htm)GENERAL INFORMATIONOTraveler: Use this form as a daily record. Original receipts must be submitted Wfor all claimed expenses. 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