Embedded Files
Code: DKC-R
SUBLETTE COUNTY SCHOOL DISTRICT #9
Business Office
115 S. Nichols St., Big Piney, WY 83113 307-276-3322
Employee PER DIEM TRAVEL REPORT / CLAIM FOR Travel
REIMBURSEMENT
Name ______________________Address___________________________________Employee ID___________________
Destination_______________________ Business Purpose of Travel______________________________________________
Non-Overnight Meal Per Diem Rate $15.00
Overnight Meal Per Diem Rate In State $60.00 ($45.00 depart/return date)
Overnight Meal Per Diem Rate Out of State $75.00($56.25 depart/return date)
Were you required to stay overnight? _____Yes (OVERNIGHT TRIP) ______No (DAY TRIP)
Actual Depart Date_________ Time ______am _____pm Actual Return Date_________ Time______ am _______pm
DAY, DATE, TAXI TO AND FROM AIRPORT ONLY, PER DIEM (75% ON TRAVEL DEPARTURE AND RETURN DATES), LODGING ACTUAL RECEIPTS (ONLY IF DISTRICT HAS NOT PAID DIRECTLY), DAILY TOTAL
SUN
MON
TUES
WED
THURS
FRI
SAT
Please attach conference documentation (ie agenda). Claims without documentation will not be processed.
TOTAL REIMBURSEMENT $___________
I certify, under penalty of perjury and subject to the provisions of WS 6-5-303 and its penalties, that the foregoing claim is a true and just record of necessary expenses paid by me while on official school business and for which I am legally entitled to reimbursement by SCSD#9. I do further certify that no part of the foregoing claim has been paid by SCSD#9 or any other source.
Dated____________ __________________________________
Signature of Claimant
Administrator/Grant Manager Signature_________________________________
Superintendent/Designee Signature____________________________________
Budget Code ________________________________Amount $_______________________
Budget Code ________________________________Amount $_______________________
_____________________________________________________________________________________________
1. It is the responsibility of the traveler to read and understand Sublette County School District # 9’s Travel Guidelines.
2. All Reimbursed Day Trip travel, which is a fringe benefit to the employee, will be taxed as such and remitted to you in your monthly paycheck.
3. 3.Trips which require an overnight stay are not taxable income to the employee and payments will be issued after the monthly board of trustee meeting if received by the 1st Friday of each month in the district business office.
4. Per diem rates for the day departing and the day returning are 75% of daily rate.
5. You need not submit meal receipts. Receipts for lodging and miscellaneous items must be submitted with this report.
DKC- R Effective 07/01/2023
Adopted: 6/20/23
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