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SCORE-Bench

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ATX02 0235775
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Source: https://www.industrydocuments.ucsf.edu/docs/pqlp0022
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Name
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Dr. Mark Hegsted
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Travel Order No. ___
Meeting of Prevention Subcommittee
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TRAVEL EXPENSES
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Please fill in the information requested below and return in the enclosed envelope in order that a voucher covering reimbursement for expenses incurred in connection with official travel orders may be prepared.
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Receipts required: Transportation (Ticket Stubs) ___ Lodging ___ Taxi Fares Over $15.00 ___
If a privately owned automobile is used, please give odometer reading for departure and arrival to each place, and list tolls and parking fees.
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Date Time Limousine Taxi
12/16/83 6 AM Depart from residence/place of business $ 25 miles $ odometer readings 13560-13581
12/16 7:50 A M Depart from Boston
Airline and Flight No. Ea 869
12/16 8:30 Arrive at Washington, DC airport (round trip) $269.00 $8.75
Expenses: 1st Day 2nd Day
Breakfast $ 2.50 $ ___
Lunch 3.75 ___
Dinner ___ ___
Lodging ___ ___
Stopovers - please complete:
___ Depart from ___ ___ ___ ___
Airline and Flight No. ___
___ Arrive at ___ ___ ___
Expenses: 1st Day 2nd Day
Breakfast $ ___ $ ___
Lunch ___ ___
Dinner ___ ___
Lodging ___ ___