EAST IRONDEQUOIT CENTRAL SCHOOL

Conference Reimbursement Request

Employee Name ______Date(s) of Conference ______

Employee Home Address ______PO # ______

Name of Conference ______Location ______

Complete Record of Conference Expenses

Date of Expense / Total
Lodging
Registration
Air/Rail Fare
Mileage
(detail below)
Parking & Tolls
Car Rental/Taxi
Meals
Telephone
Miscellaneous
(specify)
Total

Itemize and Deduct Prepaid, Purchase Orders and Purchasing Card Expenses and Previous Reimbursements

Item / Type / Amount
Deduct Total

Amount Claimed for Reimbursement

Mileage Reimbursement Calculation

Date / From / To / Miles / x Rate / Total
.55
.55
.55
.55

Total

Instructions for Completing Conference Reimbursement Request

You are responsible for submitting a claim that includes only actual expenses for the conference you attended. Your claim must conform with district policy #4180, regulation #4180-R and other directives as provided to you by the district. These documents are available on EINET. Guidance was also provided to you with your approved conference attendance request.

In order to verify that expenses fall within per diem regulations, they must be submitted on this form and must be broken down by date.

Include all expenses of your conference attendance for which the district will reimburse you or for which the district will pay directly. In this way all of your conference expenses will be reflected in a single form. Do not include expenses of a purely personal nature. They should be deducted from all amounts submitted. Attach additional pages, if necessary.

Expense Breakdown

Date of Expense: You should enter each date for which expenses reimbursement is claimed in this row and itemize the expenses in the column below.

Lodging: This row should include hotel bills including out-of-state taxes. It should not include meals, telephone calls or other charges that appear on the hotel bill. These must be broken out separately. Please be aware of the maximum per diem reimbursement.

Registration: Include the cost of your conference registration even if the district prepaid it.

Mileage: Include dollar amounts only. The calculation of these amounts should be made in the “Mileage Reimbursement Calculation” section.

Meals: Please be aware of the maximum per diem reimbursement amount. You should also note that this maximum is reduced if some meals are included in conference registration costs. The district will reimburse you for New York State taxes on meals although you are encouraged to attempt to take advantage of the district’s tax exempt status to reduce costs. You will also be reimbursed for reasonable gratuities (no more than 20%).

Telephone: You may submit up to $7.50 per day for telephone calls home if you travel outside of normal work hours.

Miscellaneous: You should specify the nature of any other necessary expenses of conference attendance for which you are eligible to be reimbursed.

Itemize and Deduct Prepaid, Purchase Orders and Purchasing Card Expenses

In this section you should list any expenses that have been included in the expense breakdown but for which you should not be reimbursed. For instance, you should show prepaid expenses for registration fees or purchase orders issued for hotels in the expense breakdown and then deduct them in this section.

Type: You should enter “district prepaid”, “purchase order” or “purchasing card” or “previously reimbursed” in this column.

Amount Claimed for Reimbursement: This should be the result of subtracting the “Deduct Total” amount from the total in the expense breakdown. This is the amount for which you are claiming reimbursement.

Mileage Reimbursement Calculation

Please include the requested specific information about your mileage claim and carry the daily totals to the mileage row in the expense breakdown. Please attach MapQuest driving directions or a similar resource as verification of your claim.

Signatures

All reimbursement claims must be signed by both the employee and the employee’s supervisor (principal, director, asst. superintendent, etc.). Your signature indicates that you are submitting a valid claim and that are providing consent for the district to recover any overpayments made to you through payroll deduction or other legal means.