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Name: Business Purpose : Destination(s): Trip's Start Date

Travel Expense Reporting 2011

30-Dec-99

31-Dec-99

10-Jan-04

11-Jan-04

12-Jan-04

13-Jan-04

14-Jan-04

1-Jan-00

4-Jan-04

5-Jan-04

6-Jan-04

7-Jan-04

8-Jan-04

9-Jan-04

TOTAL Transportation Air Taxi Car Rental Fuel Mileage Parking Other (Explain) Lodging Daily Rate Parking (at hotel) Internet Other (Explain) Other (Explain) Meals for Self/Employees self <addt'l employee self, name(s)> Business Meals and Entertainment <Company, Names and Titles, Business Purpose> <Company, Names and Titles, Business Purpose> <Company, Names and Titles, Business Purpose> Other Internet Laundy Service Other (Explain) DAILY TOTALS 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 SUBTOTAL ADVANCES TOTAL REIMBURSEMENT 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 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Employee Signature

Date

Manager's Signature

Date

Department Sales Marketing Product Management Engineering G&A

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