Travel Expense Report (Local)

Name: Sharon A. Dill Date Prepared: 4/14/06

Purpose of Travel: Support for ELV Payload Web Design Office: Cape Canaveral, Fl

Charge Code: I0018.401.001.205

Current POV Rate = 0.445 / mile

Mode of If Personal Auto, Fares/other
Date Travel From / To Type enter mileage charges Misc *
4/12/06 POV Cocoa to Orlando Mileag 120 $53.40 $5.25
e
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Subtotals: $53.40 $5.25
Total: $58.65

* Specify charge code if necessary. “Other” expenses must be explained in detail:

I certify that the itemized accounts are actual and necessary expenses incurred by me in the
performance of official business.

Employee Signature Date

Approval: Accounting:

Trip No.:

Project Manager Signature Date

VP / General Manager Signature Date

Form Revised: 01/06/06