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Travel Advance Request Form
 
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Travel Advance Request Form

PLEASE COMPLETE THE FOLLOWING INFORMATION:

All Travel advances will be paid @ 100% reimbursement rate. It is very important that the information below is filled out correctly for proper payment.

Name: Social Security #:

Organization Name:

Business Address:

City:   State:   Zip:

Work Phone:   Email:

Purpose of Trip:   Please keep description under 75 characters.

Origin:   Destination:

 
What date and time would you DEPART? What date and time would you RETURN?
Date: Time:
Date: Time:

Þ Are you driving home everyday?

Þ Are you driving your own personal vehicle? **NOTE: You cannot claim mileage on  State vehicles.

*** Trip Mileage? Official map mileage will be used.

NOTE:  Upon completion of your travel, you MUST complete the Judicial Education Center Mileage/Per Diem Reimbursement form for any changes that may have occurred after receiving your advance payment from the Judicial Education Center. Any amounts that are owed or overpaid to you will be resolved at that time.

I HEREBY CERTIFY THE FACTS STATED ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.

Signature (type your name):


Copyright Institute of Public Law
Judicial Education Center
MSC11 6060
1 University of New Mexico
Albuquerque, NM 87131-0001
505-277-5006
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