Contribution Funds for Non-governmental Organizations - a Handbook

Appendix D: Travel Claim Form

Traveller's name:

Telephone number (work):

Telephone number (home):

Telephone number (other):

Date of travel:

From to

Travel destination:

Purpose of the travel:

Travel related to which program?:

    Total Amounts Voucher number
A Amount of the advance (if applicable) $0.00  
B Vehicle rental: (a) $0.00  
Airfare: (a) $0.00  
C Taxi : (a) $0.00  
D Private Transportation:
$0.00  
E Accommodation (a)
Duration of the stay:
$0.00  
F All Other Expenses (Specify below): (a)
Please specify:
$0.00  
G Meals and Incidentals (no receipt) : $0.00  

G Composite of the meals allocated **

  # Rate    
    Grand Total : $0.00
Breakfasts:   @ Total: $0.00
Lunch:   @ Total: $0.00
Dinner:   @ Total: $0.00
Incidental allowance:   @ Total: $0.00


Total expenditures (B+C+D+E+F+G+H)
$0.00
Less advance if any (A)
$0.00
Payable amount *
$0.00

* The amount due to the claimant is calculated as follows:

* =(B+C+D+E+F+G) - A

I certify that the time and amounts included in this claim were incurred on authorized business travel. I also certify that the time and amounts claimed conform to the Travel Directives of the Organization.

Signature (Traveller):
Date:

Certified by the responsible Manager or Director of the organization.

Signature (Approved by) :
Date:

(a) All original receipts related to the expenditures claimed on this travel form should be attached to this claim.

** http://www.njc-cnm.gc.ca/doc.php?sid=3&lang=eng
The above website is the Treasury Board travel directives, hosted by the Natural Joint Council. It is used by the Federal Government for travel claims regarding Meal allowances, Kilometric rates and all other rules and regulations pertaining to Travelers.

JUS/PA-2 (rev. 1/2012)

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