Form FI51A "State Employee Travel Reimbursement Request for in-State Travel" - Utah

What Is Form FI51A?

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

Form Details:

  • Released on January 1, 2020;
  • The latest edition provided by the Utah Department of Administrative Services;
  • 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 FI51A by clicking the link below or browse more documents and templates provided by the Utah Department of Administrative Services.

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Download Form FI51A "State Employee Travel Reimbursement Request for in-State Travel" - Utah

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Control Number (Not saved in FINET)
Control Number (Not saved in FINET)
Document Date
FI51A CY20
AR
Revised: 01/2020
FINET Transaction ID
Division of Finance
Division of Finance
*Vendor Code (EIN)
*Phone
Code
Dept
Document Number
00000T
D
*Traveler Name
Departure Date
Departure Time
Destination
*Department / Unit
Return Date
Return Time
Street Address
City
State
Zip Code
*Department Name
Auto Fill Enabled
UT
*Division Name
*Division Name
Clear Form
Accounting Period
Fiscal Year
Budget Fiscal Year
Business Phone
Meal Allowance
Lodging
Mileage
Mileage
Transportation
Registration
Miscellaneous
6132
6005
6006
6003
6002
6004
6007
6276
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Grand Total of All Travel
$0.00
Additional Comments
$0.00
( Less) Travel Advance Clearing, or Other
(
Less) Transportation Expenses Paid by the State
$0.00
(Less) Registration Paid by the State
$0.00
(Less) Lodging Paid by the State
$0.00
(Less) Meals Paid on Travel Card
$0.00
(Less) Business Phone Paid by the State
$0.00
(Less) Miscellaneous Expenses Paid by the State
$0.00
Due To / (From) Traveler
$0.00
Funding
Object
$ Amount
Fund
Dept
Unit
Appr
Activity
Function
Program
Phase
6132
$0.00
6005
$0.00
6006
$0.00
6003
$0.00
6002
$0.00
6004
$0.00
6007
$0.00
6048
$0.00
6276
$0.00
Tota l
Due To / (From) Traveler
Amount Difference
$0.00
$0.00
$0.00
I, the traveler, hereby certify that all items of expense included in this statement were
incurred in the discharge of authorized official business and that the
Traveler's Title
amounts are correct and proper.
*Traveler's Signature
The undersigned hereby certify that the expenses on this form were authorized as essential to
official state business and payment thereof will not exceed appropriation.
*Budget & Accounting Officer or Authorized Agent
*Required Fields
*Dept. Head or Authorized Agent Approval
(Can be the same as B&A Officer or Auth. Agent.)
Control Number (Not saved in FINET)
Control Number (Not saved in FINET)
Document Date
FI51A CY20
AR
Revised: 01/2020
FINET Transaction ID
Division of Finance
Division of Finance
*Vendor Code (EIN)
*Phone
Code
Dept
Document Number
00000T
D
*Traveler Name
Departure Date
Departure Time
Destination
*Department / Unit
Return Date
Return Time
Street Address
City
State
Zip Code
*Department Name
Auto Fill Enabled
UT
*Division Name
*Division Name
Clear Form
Accounting Period
Fiscal Year
Budget Fiscal Year
Business Phone
Meal Allowance
Lodging
Mileage
Mileage
Transportation
Registration
Miscellaneous
6132
6005
6006
6003
6002
6004
6007
6276
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Grand Total of All Travel
$0.00
Additional Comments
$0.00
( Less) Travel Advance Clearing, or Other
(
Less) Transportation Expenses Paid by the State
$0.00
(Less) Registration Paid by the State
$0.00
(Less) Lodging Paid by the State
$0.00
(Less) Meals Paid on Travel Card
$0.00
(Less) Business Phone Paid by the State
$0.00
(Less) Miscellaneous Expenses Paid by the State
$0.00
Due To / (From) Traveler
$0.00
Funding
Object
$ Amount
Fund
Dept
Unit
Appr
Activity
Function
Program
Phase
6132
$0.00
6005
$0.00
6006
$0.00
6003
$0.00
6002
$0.00
6004
$0.00
6007
$0.00
6048
$0.00
6276
$0.00
Tota l
Due To / (From) Traveler
Amount Difference
$0.00
$0.00
$0.00
I, the traveler, hereby certify that all items of expense included in this statement were
incurred in the discharge of authorized official business and that the
Traveler's Title
amounts are correct and proper.
*Traveler's Signature
The undersigned hereby certify that the expenses on this form were authorized as essential to
official state business and payment thereof will not exceed appropriation.
*Budget & Accounting Officer or Authorized Agent
*Required Fields
*Dept. Head or Authorized Agent Approval
(Can be the same as B&A Officer or Auth. Agent.)
Meals & Lodging
Itinerary
Total
Lodging
Date
Time
Breakfast
Lunch
Dinner
From
To
Meals
Amount
MM/DD/YYYY
HH:MM AM/PM
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Totals
$0.00
$0.00
Miscellaneous
Registration
Business
Personal
Dates
Other
Other Description
Fees
Phone
Phone
MM/DD/YYYY
Tota ls
$0.00
$0.00
$0.00
$0.00
Transportation
Private Vehicle
Transportation
Transportation
Date
Code
Amount
Mileage
Rate
Amount
MM/DD/YYYY
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
N/A
$0.00
Tota l
Tota l
$0.00
$0.00
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