FY25 Hematology Expense Reimbursement Form

FY25 Hematology Expense Reimbursement Form

For any questions, please contact your admin directly!

Are you faculty, staff, or a student/postdoc?*

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Faculty Name*

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WHO - Requester Name*

Requester's email*

Processing Admin*

For Mullally Lab, please choose Division Chief Admin - Aanchal Jain

Select

Transaction Type*

Select

Are these expenses conference related?*

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Conference Name*

Attach a copy of the conference agenda below.

PTA Name/Number*

List the PTA number to use for this expense.

For STAP, please enter PTA 1089542-8-AAPAA. Please also download the form here and attach a completed copy.

Personal Expenses

Please select "Yes" if you had a personal leg added to this trip or traveled outside of the conference period.

Select or enter value

WHAT - Personal Expenses*

Please provide details for the personal expense and the price comparison.

Document a Lodging Comparison

Document a Flight Comparison

Total Amount ($)*

Please enter the amount of the total reimbursement

Vendor Name

Amount - Non-Conference*

WHAT*

WHAT - Conference Expense Details*

Please select all the categories that apply to this reimbursement – only if you have the required receipts with payment method (last 4 digits showing)

Enter the amount for each item in the following fields.

Select

WHERE*

(e.g. Austin, Texas)

Please also list the name of the country for expenses incurred internationally.

WHEN*

WHEN - Start Date*

WHEN - End Date*

WHY - Conference*

Describe the benefit to Stanford (if traveling on Stanford funds) or the sponsored projects (if traveling on PIs' sponsored funds).

WHY - Non-Conference Expense*

Describe the benefit to Stanford or the sponsored project (if sponsored funding is used).

Conference Registration Fees - Amount

Airline Name

Airfare - Amount

Hotel Name

Lodging - Amount

A copy of the final paid hotel folio listing the daily breakdown and payment information is required.

Meal Reimbursement Method

Required to select the Per Diem method if you are traveling on sponsored projects (PTAs).

Additional info for Per Diem may be found on Travel Meals policy page.

Select or enter value

Meals Date

Amount - Breakfast

Travel Meal Maximum for Breakfast is $20

Amount - Lunch

Travel Meal Maximum for Lunch is $30

Amount - Dinner

Travel Meal Maximum for Dinner is $40

Per Diem - Meals NOT paid Out-of-Pocket

List the meals NOT paid by the traveler (e.g. Breakfast on 11/01, Lunch on 11/03).

They will be deducted out from Per Diem per the university policies.

Ground Transportation - Amount

Parking - Amount

Mileage - Round-trip Distance

Up to 350 Miles Round-Trip.

Please attach a copy of the google map showing the mileage distance.

Other Expenses - Amount

Other Expenses - Description

File Upload*

Please submit PDF's only.

Add a note in the name of the file to streamline processing.

E.g. 20241025_RequesterName_Hotel Folio

Drag and drop files here or

Send me a copy of my responses

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