Policy

2:125-E1 Board Member Expense Reimbursement Form

Submit to the Superintendent, who will include this request in the monthly list of bills presented to the School Board. Please print and attach receipts for all expenditures. Use of this form is required by 2:125-E3, Resolution to Regulate Expense Reimbursements. Please print.

Name:                                                                         

Title/Office:                            

Travel Destination:                                                     

Purpose:                                  

Departure Date:                                                          

Return Date:                           

  Receipts attached                        Request Date:                         

  Approved expense advancement (voucher) attached, if applicable* (Completed 2:125-E2, Board Member Estimated Expense Approval Form.)

Actual Expense Report

* Board members will be reimbursed for actual and necessary expenses that exceed the amount advanced, but must refund any expense advancement that exceeds the actual and necessary expenses incurred. (105 ILCS 5/10-22.32)

Auto Travel Allowance:                      per mile
 

Date

Mileage

Miles    Cost

Comm.

Travel Expenses

 

Lodging

Meals

Bkfst | Lunch | Dinner

Other

Item                     Cost

Daily

Total

Subtotal                                                                                        
Advances
TOTAL (a negative amount indicates refund due from Board member) $

Submitting Board Member’s Signature:  _________________________________

Date:  ________________________

Superintendent Signature:  ___________________________________

Date:  _______________________

School Board Action (circle one):  

Approved                            Denied

Approved in Part               Exceeds Maximum Allowable Amount

Date Adopted:  December 20, 2016