Form AC132-S "Employee Report of Travel Expenses and Claim for Payment" - New York

What Is Form AC132-S?

This is a legal form that was released by the Office of the New York State Comptroller - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2017;
  • The latest edition provided by the Office of the New York State Comptroller;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AC132-S by clicking the link below or browse more documents and templates provided by the Office of the New York State Comptroller.

ADVERTISEMENT
ADVERTISEMENT

Download Form AC132-S "Employee Report of Travel Expenses and Claim for Payment" - New York

Download PDF

Fill PDF online

Rate (4.4 / 5) 14 votes
AC 132-S (Effective 9/17)
EMPLOYEE REPORT OF TRAVEL
State
of
EXPENSES AND CLAIM FOR PAYMENT
New York
Agency Name
Business Unit/Department Code
Official Station Zip
Employee ID
Official Station Address
Last Name
First Name
MI
Suffix
Home Address
City
State
Zip
Business Purpose
Travel Description
Start Location Street
Start Location Zip
Check if used:
Corp Card
Advance
Direct Bill
Destination Location Street
Destination Location Zip
Normal Work Hours
Travel Start Date and Time
Travel End Date and Time
If more space is required in any section, use the
1. Indicate All Travel
Totals
2. Summary
Amount
associated detail form (number shown in parenthesis
Expenses
below)
Lodging
A. Total Travel Expenses
B. Subtract Amount Paid with
Travel Advance
Transportation (AC 3259-S)
C. Subtract Amount Billed to
Corp Card (AC 3256-S)
D. Other Direct Bill to Agency
(Specify)
Meals (AC 3258-
Overnight Per Diem
@ $
each =
S)
Additional Breakfast
@ $
each + Additional Dinner
@ $
each =
Day Trip Breakfast
@ $
each + Day Trip Dinner
@ $
each =
E. Other Adjustments (Specify)
Mileage Claimed (AC 160-S)
@
¢ per mile =
Incidental Expenses – List (AC 3258-S)
Total Travel Expenses – Enter in Section 2 Line A
Total Amount Claimed
Traveler’s Certification
I hereby certify that the above account and attached schedules are just, true and correct, that no part thereof has been paid, except as stated therein, and that the balance
therein stated is actually due and owing, and that the amounts claimed were necessary an incurred in the performance of my official duties.
Signature
Title
Date
Supervisor’s Certification (if required)
I, the claimant’s supervisor, certify that this account has been examined and to the best of my knowledge and belief, the amounts claimed therein were necessary for the
performance of the claimant’s authorized official duties.
Signature of Supervisor
Title
Date
Expense Report
Travel Auth. Code
FOR AGENCY USE ONLY
Number
Entered by
Date
AC 132-S (Effective 9/17)
EMPLOYEE REPORT OF TRAVEL
State
of
EXPENSES AND CLAIM FOR PAYMENT
New York
Agency Name
Business Unit/Department Code
Official Station Zip
Employee ID
Official Station Address
Last Name
First Name
MI
Suffix
Home Address
City
State
Zip
Business Purpose
Travel Description
Start Location Street
Start Location Zip
Check if used:
Corp Card
Advance
Direct Bill
Destination Location Street
Destination Location Zip
Normal Work Hours
Travel Start Date and Time
Travel End Date and Time
If more space is required in any section, use the
1. Indicate All Travel
Totals
2. Summary
Amount
associated detail form (number shown in parenthesis
Expenses
below)
Lodging
A. Total Travel Expenses
B. Subtract Amount Paid with
Travel Advance
Transportation (AC 3259-S)
C. Subtract Amount Billed to
Corp Card (AC 3256-S)
D. Other Direct Bill to Agency
(Specify)
Meals (AC 3258-
Overnight Per Diem
@ $
each =
S)
Additional Breakfast
@ $
each + Additional Dinner
@ $
each =
Day Trip Breakfast
@ $
each + Day Trip Dinner
@ $
each =
E. Other Adjustments (Specify)
Mileage Claimed (AC 160-S)
@
¢ per mile =
Incidental Expenses – List (AC 3258-S)
Total Travel Expenses – Enter in Section 2 Line A
Total Amount Claimed
Traveler’s Certification
I hereby certify that the above account and attached schedules are just, true and correct, that no part thereof has been paid, except as stated therein, and that the balance
therein stated is actually due and owing, and that the amounts claimed were necessary an incurred in the performance of my official duties.
Signature
Title
Date
Supervisor’s Certification (if required)
I, the claimant’s supervisor, certify that this account has been examined and to the best of my knowledge and belief, the amounts claimed therein were necessary for the
performance of the claimant’s authorized official duties.
Signature of Supervisor
Title
Date
Expense Report
Travel Auth. Code
FOR AGENCY USE ONLY
Number
Entered by
Date