Form NIH2926-1 "Nih Travel Waiver Request Form for Senior Travel Official Approval"

What Is Form NIH2926-1?

This is a legal form that was released by the U.S. Department of Health and Human Services - National Institutes of Health on November 1, 2013 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2013;
  • The latest available edition released by the U.S. Department of Health and Human Services - National Institutes of Health;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form NIH2926-1 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - National Institutes of Health.

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Download Form NIH2926-1 "Nih Travel Waiver Request Form for Senior Travel Official Approval"

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NIH TRAVEL WAIVER REQUEST FORM
FOR SENIOR TRAVEL OFFICIAL APPROVAL
Traveler:
Title:
IC:
IC Point of Contact:
Conference/Meeting Title:
Location:
Dates:
Conference/Meeting Title:
Location:
Dates:
Conference/Meeting Title:
Location:
Dates:
Domestic
International
(NIH Funded)
(NIH Funded)
Domestic
(Sponsoring Organization):
International
(Sponsoring Organization):
Check all boxes that apply
Leave in Conjunction with HHS-348 Sponsored Travel
(International only)
Leave (
In excess of the number of days permitted by HHS guidelines which is based on the number of lodging
nights, but in any case, cannot exceed three (3) days. Please provide in the narrative section the number of
lodging nights involved, the number of official TDY days and the number of annual leave days being requested.)
Premium Class
(other than First Class)
“14 Hour Rule”
(Intervening domestic stops and actual domestic flying time on outbound flight)
“14 Hour Rule”
(Returning flight)
Premium Class
(First Class)
HHS-348 Sponsored In-Cash
Sponsor internal operations cannot support their making in-kind travel arrangements
There are no known issues of sponsor not providing timely cash reimbursement
Sponsor letter attached
*Only in-cash requests $500 or greater may be waived by the STO. Any request below
this amount cannot be accepted.
**A blanket waiver exists for in-cash sponsor funding provided by FASEB, Keystone and Gordon Research
regardless of dollar amount. As such, STO waiver is not required.
HHS-348 Sponsored In-Kind
(Over 13 lodging nights)
Payment of Discretionary Relocation Allowance
(See HHS/HR Manual Instructions 572-1 1/16/2012)
NIH 2926-1 (11/13)
Page 1
NIH TRAVEL WAIVER REQUEST FORM
FOR SENIOR TRAVEL OFFICIAL APPROVAL
Traveler:
Title:
IC:
IC Point of Contact:
Conference/Meeting Title:
Location:
Dates:
Conference/Meeting Title:
Location:
Dates:
Conference/Meeting Title:
Location:
Dates:
Domestic
International
(NIH Funded)
(NIH Funded)
Domestic
(Sponsoring Organization):
International
(Sponsoring Organization):
Check all boxes that apply
Leave in Conjunction with HHS-348 Sponsored Travel
(International only)
Leave (
In excess of the number of days permitted by HHS guidelines which is based on the number of lodging
nights, but in any case, cannot exceed three (3) days. Please provide in the narrative section the number of
lodging nights involved, the number of official TDY days and the number of annual leave days being requested.)
Premium Class
(other than First Class)
“14 Hour Rule”
(Intervening domestic stops and actual domestic flying time on outbound flight)
“14 Hour Rule”
(Returning flight)
Premium Class
(First Class)
HHS-348 Sponsored In-Cash
Sponsor internal operations cannot support their making in-kind travel arrangements
There are no known issues of sponsor not providing timely cash reimbursement
Sponsor letter attached
*Only in-cash requests $500 or greater may be waived by the STO. Any request below
this amount cannot be accepted.
**A blanket waiver exists for in-cash sponsor funding provided by FASEB, Keystone and Gordon Research
regardless of dollar amount. As such, STO waiver is not required.
HHS-348 Sponsored In-Kind
(Over 13 lodging nights)
Payment of Discretionary Relocation Allowance
(See HHS/HR Manual Instructions 572-1 1/16/2012)
NIH 2926-1 (11/13)
Page 1
NIH TRAVEL WAIVER REQUEST FORM
FOR SENIOR TRAVEL OFFICIAL APPROVAL
Complete Narrative Justification and Signature Block on Page 2 of the form.
Complete Narrative Justification: (Attach other than coach class justification memo)
EO Signature:
Date:
NIH STO/CTMC Determination: Approval:
Disapproval:
NIH STO Signature:
Date:
**As of 2012 this form supersedes the NIH International Travel Waiver Form
NIH 2926-1 (11/13)
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