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VRR Employee Expense Reimbursement Request

Employee Information

Employee Name(Required)
Employee Address(Required)
At this time reimbursements will be done through paper checks mailed to employees home address.

Purpose of Travel / Expense and Primary Team Expense is Assigned Too.

Your reimbursement request will be routed to the appropriate team lead for review first. All Con Ed expenses will be routed to Admin Team not Clinical or other teams.
If this belongs to a particular program please state here. Example :Mental Health First Aid

Dates - Mileage - Per Diem Rates - Hotel Cost

Date Travel Started
For calculating Per Diem.
Date Travel Ended (Returned)
For calculating Per Diem.
For calculating Per Diem.

Per Diem Rates

Per Diem rate for destination - use GSA link in team portal
Travel on first and last day is paid at lower rate
Only FULL days at destination day of travel to and from destination is paid at First and Last Daily Rate.
(First + Last Day Rate) + (Daily Full Rate * Number of Full Days)


If personal vehicle was driven. Actual Mileage from Veterans Recovery Resources - 1156 Spring Hill Ave to destination and return.
Mileage is reimbursed at the above rate.
Multiply mileage (ROUND TRIP) by $0.585

GSA Travel Total

Add Per Diem + Mileage + Lodging
(Number of Full Days * Per Diem Daily Rate) + First Day Rate + Last Day Rate (If ONLY traveling for one day only First Day Travel Rate is paid)
Multiply actual mileage by $0.585 to come up with Mileage Reimbursement Total.
Total lodging cost paid for travel.

Additional Expenses

Expense Description - Expense Total
List additional expenses and total. (use + on side to add additional expenses)

Reimbursment Request Total

Add - Per Diem Total + Mileage Total + Lodging + Any Additional Expenses
I understand that this reimbursement request is an an estimation using the GSA website for travel allowed amounts and additional expenses and is subject to approval.(Required)
Drop files here or
Max. file size: 50 MB.
    Upload Receipts from hotel stay as well as any other relevant claimed expenses.


    When you click submit you will be redirected to the Expense Tracker. Please input the information on that tracker so that you may track and know where your reimbursement request is at in the process. IF PROMPTED TO SIGN IN USE THE FOLLOWING: email: pw: P@$$word1
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