Form EWR-1 "eWaiver Request Form" - Mississippi

What Is Form EWR-1?

This is a legal form that was released by the Mississippi Department of Finance and Administration - a government authority operating within Mississippi. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 4, 2019;
  • The latest edition provided by the Mississippi Department of Finance and Administration;
  • 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 printable version of Form EWR-1 by clicking the link below or browse more documents and templates provided by the Mississippi Department of Finance and Administration.

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Download Form EWR-1 "eWaiver Request Form" - Mississippi

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EWR-1 Form
Revised: 12/4/19
eWaiver Request Form
Office of Purchasing and Travel
This form is to be used to request an eWaiver from any of the standard travel procedures set forth in the
Office of Purchasing and Travel, Travel Manual. The request should be submitted via email to
travel@dfa.ms.gov
prior to making any reservations or commitments.
Date: ___________ Agency: __________________________________________________________________
Name of Traveler: ___________________________________________ Phone: _________________________
Return eWaiver via E-Mail to: __________________________________________________________________
Travel Date(s): ______________________________________________________________________________
Destination(s): ______________________________________________________________________________
Purpose of Travel: ___________________________________________________________________________
Amount of Reimbursement Requested: _________________
_____ Requesting authority to pay an amount greater than state contract
_____ Requesting authority to rent a vehicle with a cost greater than the mid-size on state contract
_____ Requesting authority to purchase vehicle rental insurance
_____ Requesting authority to rent a vehicle not on current contract
_____ Requesting authority to pay a hotel other than the conference hotel
_____ Requesting authority to pay greater than the least expensive cost comparison for airline tickets
_____ Requesting authority to pay first-class or business-class airfare (six hour or longer flight segment required)
_____ Other
Please explain your request. Include any and all information which would prove that approval of the eWaiver would be
economical and in the best interest of the state and/or the approval of the eWaiver is necessary for some other reason.
Failure to provide adequate information will be cause for delays and potentially the rejection of the request (attach
additional pages if needed). We must be able to determine the anticipated cost to the state and any anticipated
savings. You must include all applicable cost information (example: cost comparisons showing savings,
conference hotel rate vs. actual rate paid, etc.).
Agency
Approval
Agency Head or Designee
Date
Approved:
Office of Purchasing and Travel
Date
EWR-1 Form
Revised: 12/4/19
eWaiver Request Form
Office of Purchasing and Travel
This form is to be used to request an eWaiver from any of the standard travel procedures set forth in the
Office of Purchasing and Travel, Travel Manual. The request should be submitted via email to
travel@dfa.ms.gov
prior to making any reservations or commitments.
Date: ___________ Agency: __________________________________________________________________
Name of Traveler: ___________________________________________ Phone: _________________________
Return eWaiver via E-Mail to: __________________________________________________________________
Travel Date(s): ______________________________________________________________________________
Destination(s): ______________________________________________________________________________
Purpose of Travel: ___________________________________________________________________________
Amount of Reimbursement Requested: _________________
_____ Requesting authority to pay an amount greater than state contract
_____ Requesting authority to rent a vehicle with a cost greater than the mid-size on state contract
_____ Requesting authority to purchase vehicle rental insurance
_____ Requesting authority to rent a vehicle not on current contract
_____ Requesting authority to pay a hotel other than the conference hotel
_____ Requesting authority to pay greater than the least expensive cost comparison for airline tickets
_____ Requesting authority to pay first-class or business-class airfare (six hour or longer flight segment required)
_____ Other
Please explain your request. Include any and all information which would prove that approval of the eWaiver would be
economical and in the best interest of the state and/or the approval of the eWaiver is necessary for some other reason.
Failure to provide adequate information will be cause for delays and potentially the rejection of the request (attach
additional pages if needed). We must be able to determine the anticipated cost to the state and any anticipated
savings. You must include all applicable cost information (example: cost comparisons showing savings,
conference hotel rate vs. actual rate paid, etc.).
Agency
Approval
Agency Head or Designee
Date
Approved:
Office of Purchasing and Travel
Date