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VALENCIA COLLEGE

DFA-1 Rev. 03-09

IN-DISTRICT TRAVEL REPORT VOUCHER

DATE

NAME (print or type) _____________________________________

Mail Code ______________

HOME ADDRESS (If applicable)

________________________ City, State Zip code

______________________________________ Street

FROM LOCATION

TO LOCATION

REASON FOR TRAVEL

TOTALS ______________________________ SIGNATURE OF TRAVELER

V0_______________ ___________ VID # DATE

APPROVED BY: _______________________ SIGNATURE Charge to: INDEX__________ /ACCT__________

• • •

(or)

MILEAGE

0.00 ___________

TOLLS/ PARKING

$0.00 __________

-$0.00 MILEAGE X RATE = $_____________ -$0.00 TOTAL AMOUNT DUE $_____________

_________ COMPLETED BY (PRINT NAME) ________________________ DATE FUND__________ ORG__________ ACCT__________ PROG__________

Please attach a printout from Yahoo, Mapquest, Google, etc. for travel to/from non-campus locations Please include home address on the form, if traveling from or to home and claiming excess miles Submit to: Accounts Payable DTC-3


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