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Accounts Payable Forms
Accounts Payable
Tel No (818) 677-3472
Fax No: (818) 677-4581
Mail Drop: 8202
Travel Expense Itemization Worksheet
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Instructions: Indicate each daily item of expense in the appropriate category and attach a receipt for each item. If a receipt is lost or otherwise unavailable, the claimant must circle the expenditure item and sign the Missing Receipt Certification section below. This worksheet will facilitate preparartion of the Travel Expense Claim form and must accompany that document for reimbursement.
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NAME: DEPARTMENT: CSUN ID#:
PHONE : TRAVEL REQUEST #: DATE:
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• Subsistance: Day 1 Day 2 Day 3 Day 4 Day 5
     Hotel:
     Breakfast:
     Lunch:
     Dinner:
     Incidentals:
• Transportation:          
     Carfare:
     Tolls:
     Parking:
     Incidentals:
• Business Expenses:        
a.
b.
c.
d.
e.
Daily Totals:
     
GRAND TOTAL:
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I hereby certify that the above information is a true statement of the travel expenses incurred by me in
accordance with the applicable Trustee procedures in the service of the California State University
and that all items shown were for the official business of the California State University.
Claimant's Signature: _________________________
Date: _______
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Missing Receipt Certification: I hereby certify that each expense as indicated on this worksheet and
for which a receipt is unavailable, is a true and actual cost incurred while on the official business of the
California State University.
Claimant's Signature: _________________________
Date: _______