Employee Expense Report Form

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Employee Expense Report Quick-Step Instructions

Section I: Employee Information


1. Select either In-State, Out-of-State, or International
a. Out-of-State or International travel requires a completed Travel Authorization attached to payment method
2. Select Report Type
a. Reimbursement- Employee has used personal funds. If the travel has not occurred, this is considered an “Advance.”
b. Advance- Employee is requesting funds for travel that has not occurred. Employees may only have one Advance at a
time. If an Advance is issued, a settlement is required.
c. Settlement- Employee received an advance and is providing documentation of actual expenses incurred. This is to
be completed 5 days from the return date.
3. Your Employee ID is the same as your “Payroll ID.” If you do not know this number, contact HR.
4. Your Dragon ID is the same as your “Tech ID.”
5. Select appropriate Bargaining Unit. If you do not know your Bargaining Unit, contact HR.
6. Do not include any expenses incurred on a University Purchasing Card or PO. Only include expenses for which
reimbursement is being requested.

Section II: Travel Itinerary and Expenses


1. Complete the entire daily travel expenses
a. Your departure and arrival time will indicate if you are to receive reimbursable meals:
i. Breakfast- Reimbursed when trip begins before 6am
ii. Lunch- Reimbursed when employee is in travel status through the normal lunch period and is 35 miles from
campus
iii. Dinner- Reimbursed when trip ends after 7pm
b. Mileage
i. State-owned vehicle available but declined- student will be reimbursed 55.5 cents per mile (.555) for travel
on or after 07/01/2022
1. Rate prior to 06/30/2022 is 51.5 cents per mile (.515)
ii. State-owned vehicle not available- student will be reimbursed 62.5 cents per mile (.625) for travel on or
after 07/01/2022
1. Rate prior to 06/30/2022 is 58.5 cents per mile (.585)
iii. Meal and Mileage reimbursement amounts *IFO and MSUAASF utilizing Professional Development funds
should refer to GSA and DoD meal rates. Include a screenshot of the rates from the websites when
submitting your expense report in order to claim a different rate. First & Last day of travel is limited to 75%
of meal and incidental total.

Section III: Other Expenses


1. Complete date and details to “Other Expenses.” This is the portion of the form to request reimbursement for airfare,
conference fees, supplies, rental car, memberships, etc.

Section IV: Cost Center Allocation


1. Complete the cost center information and amounts to equal the “Total amount to be paid to Employee.”

Important
• Complete your totals and attach documentation (including Out-of-State/International Travel Authorization)
• Obtain appropriate signatures and submit to Business Services (Owens 106) or [email protected]
• Please allow 3 weeks for processing
• If submitted 60 days after expense, the reimbursement becomes taxable and tax withholding must be taken
• For an advance settlement, Employee Expense Reports must be submitted within 5 days after travel
• Visit Business Services’ Travel and Business Expenses webpage for additional policies and procedures

Minnesota State University Moorhead is an equal opportunity educator and employer and is a member of the
Minnesota State Colleges and Universities System. This information will be made available in alternate format upon
request by contacting Disability Services at 218.477.4318 (VOICE) or 1.800.627.3529 (MRS/TTY)
Employee Expense Report

Section I: Travel Type: □In-State □Out-of-State/International (must attach travel authorization) Report Type: □Reimbursement □Advance □Settlement
Name: Travel Destination and Purpose of Expense:
Home Address:
Work Address:
Work Phone: Employee ID# Bargaining Unit: Required
Department/Office: Dragon ID # (Select)

Section II: Do not include expenses incurred on University Purchasing card or PO. Only include expenses for which reimbursement is being requested.
Daily Itinerary Daily Mileage Mileage Meal Amount
Reason for Travel Lodging Amount Daily Total
Date Time Location Mileage Rate Amount B L D
Departure
Arrival 0.00 0.00
Departure
Arrival 0.00 0.00
Departure
Arrival 0.00 0.00
Departure
Arrival 0.00 0.00
Departure
Arrival 0.00 0.00
Departure
Arrival 0.00 0.00
Section II Subtotals: 0.00 0.00 0.00 0.00 0.00 0.00

I declare under the penalties of perjury that this claim is just and correct and that no part Section III:
of it has been paid except with respect to those advance amounts herein shown and hereby Date Other Expenses Total
authorize payroll deduction of any such advances not accounted for within 28 days after
completion of trip. I have not claimed frequent flyer mileage or other travel benefits as my own.

______________________________________________________________________________
Employee’s Signature Date
Section III Subtotal: 0.00
I approve based on my knowledge of the necessity for the expense and on the basis of TOTAL OF SECTION II AND III: 0.00
compliance with all provisions of applicable policy and procedure. Less Advance (If Applicable):
TOTAL AMOUNT TO BE PAID TO EMPLOYEE:
______________________________________________________________________________
Section IV: Total amount must equal amount to be paid to employee:
Supervisor/Department Chair’s Signature Date
Cost Center number/name_______________________________________ $_____________
______________________________________________________________________________ Cost Center number/name_______________________________________ $_____________
VP/ Dean/Director’s Signature Date
Cost Center number/name_______________________________________ $_____________

Rev. 1/2020

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