Grant Expense Report

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Location: Conference Dates: From To Student Travel Expense Report (add additional expenses on separate page) Time of Date: Description / Destination (include type of transportation) Transporta Exchange tion Rate Meals Lodging A B C 0.00 0.00 0.00 Depart Arrive Totals for all travel expenses: Miscellaneous Expenses Amount Expense Description / Purpose D Total Misc: Total Expenses (A+B+C+D): 0.00 0.00 Funding GPSC Travel Grants Funding 1 Funding 2 Funding 3 Own Pocket Total Funding (Must Match Total Expenses): 0.00 I HEREBY CERTIFY THAT I AM THE PAYER FOR ALL ITEMS OF EXPENSE INCLUDED IN THE ABOVE AMOUNT AND THAT THE ITEMS WERE NECESSARY IN ATTENDING THE STATED CONFERENCE AND I DECLARE, UNDER PENALTIES OF PERJURY THAT THIS CLAIM HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLDGE AND BELIEF IS TRUE, CORRECT AND VALID CLAIM AND FOR VALUE RECEIVED..

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