Submitting a travel reimbursement form (TP)
Fill in the name and home address section of the form. If you would like your reimbursement sent to an alternate address, please fill in that information also.
Fill in the month and day of your travel
Fill in the time that you left your home, school, or workplace, and the time you returned
Fill in the location of your origination to your destination and back to your origination (ex: Sioux City to Des Moines to Sioux City)
Fill in the total miles traveled. The current rate of reimbursement is $0.39. If you did not keep track of your mileage, refer to Mapquest.com on the Internet
If you incurred a meal expense while on assignment for our agency, please indicate the actual cost of those meals in the appropriate columns. Our current maximum rate of reimbursement is $5.00 for breakfast (if you left prior to 6 AM), $8.00 for lunch and $15.00 for dinner (if you arrive back after 7 PM). If you also had an overnight stay in Des Moines for a meeting, then the meals will be non-taxable. If there was not an overnight stay, your meal will then become a taxable income to you. No receipts are needed for meal reimbursement.
If you incurred expenses for lodging, insert that information under the “lodging actual” column. Our current maximum rate of reimbursement is 55.00 plus taxes. You will need to include the hotel receipt – it must be itemized showing the name and location of lodging facility, dates, room number, number of occupants, name of guest, and charges per night. If the hotel’s original invoice does not show a zero balance, then you will also need to submit a copy of your credit card statement or front and back of your cancelled check.
If you are a Commissioner, please check the box provided in the Claimant Certification area.
Please insert your i3 identification (9 digit number starting with your last name and going onto your first name as many digits as needed followed by the last 2 numbers of your SSN) in the space provided for SSN.
Include your signature and a date. Submit the travel form and all of your required backup to whoever coordinated your meeting so that they can apply their signature before it is sent onto accounting for processing.