Actual Expenses

Transportation does not include airfare or actual mileage to destination.

Prepaid Per-Diem Expenses

Use only if you received Per diem PRIOR to travel.

Acknowledgement and Signing

Receipts for any covered expenditure up to the current GSA rate are not required. This form must be completed, signed, and returned to Illinois ENA within 30 days of the travel end date. Any reimbursement requests received more than 30 days after the end of the calendar year cannot be honored.

The current GSA rate is available HERE.

Use your mouse to sign the form, this constitutes an electronic signature and that you attest to the truthfulness and accuracy of this completed document.