SECTION 1 – Travel Request
Date Initiated:	Dates of Travel:	-
Traveler Name:
Title:	Unit:	Charge to Cost Center:
Purpose:
Location:
Carrier Requested:	Air	State Vehicle	Personal Car	Rental	Other
Reason for Car Rental Rather than Airport/Hotel Shuttle:
Carrier Name (airline, car rental co.)	Date	From	To
Estimated Cost:	Provide an educated estimate of ALL costs associated with this travel. (Travel expenses will be in accordance with travel reimbursement guidelines.)
Meals:	$	Registration:	$
Transportation:	$	Other:	$
Lodging:	$	$
Total Cost of Trip:	$
Are You Requesting Reimbursement OVER the Lodging Guidelines?	Yes	No	If Yes, Why?
Are You Requesting a Travel Advance?	Yes	No	Amount Requested:	$
Traveler Signature	Date
SECTION 2 – Travel Authorization
Employee Supervisor Name (Print)	Employee Supervisor Signature	Date
Budget Manager Name (Print)	Budget Manager Signature	Date
State Forester or Designee Name (Print)	State Forester or Designee Signature	Date
SECTION 3 – Travel Advance Request	(only completed if Travel Advance is Being Requested)
Finance Director Name (Print)	Finance Director Signature	Date
I agree to file and request reimbursement for travel expenses within five (5) working days of my return and repay the advance within 30 days of the processing of the travel reimbursement voucher. I understand that if this advance is not paid within the 30 day time frame, future travel advances may be denied. I understand and agree that this advance will be deducted from my salary paycheck should I fail to make payment according to the terms set forth above:
Check Received:	Travel Loan Check No.:	Check Amount:	$
Traveler Signature	Date
VDOF Headquarters Office/Finance Use Only
Repayment:	Date Received:	Amount:	Cash	Check
Log ID:	Completed By: