Humanities Institute Expense Report Assistance Form Humanities Institute Expense Report Assistance Form Requester name(Required) Traveler name(Required) Have you submitted a Concur Travel Request for this Trip?(Required) Yes No If you have not, please stop this form and submit a request via the following link: https://humanities.uconn.edu/humanities-institute-travel-request-assistance-form/Please describe your trip itinerary and the business purpose / justification with as much specificity as possible.(Required)Please enter the amount of AAUP/OVPR funding you were approved for this trip(Required) If you did not request funding or did not get approved for funding. Please enter $0.If applicable, please enter the department KFS number you would like to allocate the funds to. Are you looking to request a Per Diem for meals?(Required) Yes No If so, please fill out the times you departed and arrived in your destination and back below. If you had more than one stop, list in the expense details each stop's departure and arrival.Date you left for your destination Month Day Year From what city to what city? i.e., "Storrs, CT to New York City, NY"Time You Left Hours : Minutes AM PM AM/PM Time You Arrived Hours : Minutes AM PM AM/PM Date you returned home Month Day Year Time You Left Destination Hours : Minutes AM PM AM/PM Time You Arrived Home Hours : Minutes AM PM AM/PM Please list all of the expenses you would like to have reimbursed. Please be as specific as you can; include how much was charged, and how it was paid for (Travel Card, Out-of-Pocket, etc)(Required)NOTE: All items being reimbursed are required to include a receipt, preferably one with a proof of purchase.Please make sure to send all receipts related to the requested expenses above to shana.bartlett@uconn.edu. If this trip was related to a conference and you have not already, please also send a conference program or schedule, preference to one that shows your participation.(Required) I understand PhoneThis field is for validation purposes and should be left unchanged. Humanities Institute Expense Report Assistance Form Requester name(Required) Traveler name(Required) Have you submitted a Concur Travel Request for this Trip?(Required) Yes No If you have not, please stop this form and submit a request via the following link: https://humanities.uconn.edu/humanities-institute-travel-request-assistance-form/Please describe your trip itinerary and the business purpose / justification with as much specificity as possible.(Required)Please enter the amount of AAUP/OVPR funding you were approved for this trip(Required) If you did not request funding or did not get approved for funding. Please enter $0.If applicable, please enter the department KFS number you would like to allocate the funds to. Are you looking to request a Per Diem for meals?(Required) Yes No If so, please fill out the times you departed and arrived in your destination and back below. If you had more than one stop, list in the expense details each stop’s departure and arrival.Date you left for your destination Month Day Year From what city to what city? i.e., “Storrs, CT to New York City, NY”Time You Left Hours : Minutes AM PM AM/PM Time You Arrived Hours : Minutes AM PM AM/PM Date you returned home Month Day Year Time You Left Destination Hours : Minutes AM PM AM/PM Time You Arrived Home Hours : Minutes AM PM AM/PM Please list all of the expenses you would like to have reimbursed. Please be as specific as you can; include how much was charged, and how it was paid for (Travel Card, Out-of-Pocket, etc)(Required)NOTE: All items being reimbursed are required to include a receipt, preferably one with a proof of purchase.Please make sure to send all receipts related to the requested expenses above to shana.bartlett@uconn.edu. If this trip was related to a conference and you have not already, please also send a conference program or schedule, preference to one that shows your participation.(Required) I understand CommentsThis field is for validation purposes and should be left unchanged.