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  • Statement of Automobile Travel

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    Mary Zurlo Blancha
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    This document is a statement of automobile travel for expense reimbursement purposes in New York State. It requires the traveler's name, dates of travel, starting and ending points, total miles claimed, and a breakdown of actual versus claimed mileage to be reported on another expense form.

    Original Description:

    Auto Travel Fill-In

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    This document is a statement of automobile travel for expense reimbursement purposes in New York State. It requires the traveler's name, dates of travel, starting and ending points, total miles claimed, and a breakdown of actual versus claimed mileage to be reported on another expense form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    24 views1 page

    Statement of Automobile Travel

    Uploaded by

    Mary Zurlo Blancha
    This document is a statement of automobile travel for expense reimbursement purposes in New York State. It requires the traveler's name, dates of travel, starting and ending points, total miles claimed, and a breakdown of actual versus claimed mileage to be reported on another expense form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    AC160-S (Effective 1/12)

    State
    of
    New York

    STATEMENT OF AUTOMOBILE TRAVEL


    Submit with expense report

    Name

    Date

    Travel Start Date

    From

    Total Miles Claimed

    Between What Points


    To

    (Report on AC132-S or AC3257-S under Mileage)

    Travel End Date

    Actual
    Mileage

    Mileage
    Claimed

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