This document is an intrastate travel authorization form from the New Mexico Department of Labor. It requests authorization for an employee to travel within New Mexico for work purposes. The form provides spaces to include the employee's name, title, cost center information, travel dates and destination, estimated travel costs, funding sources, and requires signatures from the employee's supervisor, bureau chief, division director and secretary for approval.
Original Description:
Original Title
Department of Labor: Interstate travel authorization
This document is an intrastate travel authorization form from the New Mexico Department of Labor. It requests authorization for an employee to travel within New Mexico for work purposes. The form provides spaces to include the employee's name, title, cost center information, travel dates and destination, estimated travel costs, funding sources, and requires signatures from the employee's supervisor, bureau chief, division director and secretary for approval.
This document is an intrastate travel authorization form from the New Mexico Department of Labor. It requests authorization for an employee to travel within New Mexico for work purposes. The form provides spaces to include the employee's name, title, cost center information, travel dates and destination, estimated travel costs, funding sources, and requires signatures from the employee's supervisor, bureau chief, division director and secretary for approval.
NAME:______________________________ TITLE: ________________________ I COST CENTER NAME: ______________ DATE: _________________________ COST CENTER #:_____________________
AUTHORIZATION IS REQUESTED TO INCUR THE FOLLOWING TRAVEL EXPENSE, IN ACCORDANCE
WITH DFA REGULATION NUMBER 90-2, DEEMED NECESSARY TO THE PERFORMANCE FO OFFICIAL DUTIES, DURING THE PERIOD__________, 20__________TO _______________, 20__________ II
EMPLOYEE SIGNATURE: DATE: ____________________
ESTIMATED DATES DESTINATION AND PURPOSE OF TRIP
III
TOTAL ESTIMATE COST: $____________________
REQUEST FOR A TRAVEL ADVANCE TRAVEL TO BE PAID FROM
NON-NMDOL FUNDS IV REQUEST FOR REIMBURSEMENT REQUEST FOR RENTAL CAR OF ACTUAL EXPENSES AIRFARE
FUNDING SOURCE: ENTER PROJECT AND FUNCTION CODE THE TRAVEL EXPENSE IS TO BE CHARGED TO. IF MORE THAN ONE CODE INDICATE % THAT IS TO BE APPLIED TO EACH.
V 1)__________ __________ _____% 3)__________ __________ _____%
I CERTIFY THAT I HAVE THE MINIMUM INSURANCE COVERAGE FOR LIABILITY PROPERTY DAMAGE AND UNISURED MOTORIST WITH: COMPANY: _____________________________________________ VI POLICY COVERAGE DATE: FROM _____________________TO_______________
EMPLOYEE SIGNATURE: DATE:__________
SUPERVISOR: DATE:__________ APPROVE
DISAPPROVE
BUREAU CHIEF: DATE:__________ APPROVE
VII DISAPPROVE
DIVISION DIRECTOR: DATE:__________ APPROVE
DISAPPROVE
SECRETARY: DATE:__________ APPROVE
DISAPPROVE SEE INSTRUCTIONS ES100.8 001-0058 (REV 7/90) DISTRIBUTION: White_Voucher Copy-Financial Management Canary-Cost Center Pink-Emp
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