What qualifies for per diem?

Per diem generally covers lodging, meals, and incidental expenses related to business travel. Company policy may limit eligible items and specify when receipts are required.

How soon must I submit a request?

Submit within your employer's stated window, commonly 30 days after travel ends; late submissions may be denied or require additional approvals.

Can I e-sign the form?

Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent and consent are documented and records are retained.

Receipts are typically required for lodging and for any expenses exceeding per diem thresholds; company policy will specify thresholds and acceptable documentation.

Will per diem be taxed?

Per diem that exceeds IRS substantiated rates or is not compliant with policy may be taxable; consult payroll for tax consequences and reporting.

Who to contact for disputes?

Contact your supervisor or accounts payable for disputes. Retain copies of the signed form and attachments to support any appeal or audit review.

Electronic Signature
Templates
HR
Employee Per Diem Request Form

Employee Per Diem Request Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYEE PER DIEM REQUEST FORM

Purpose: Use this form to request per diem reimbursement for authorized business travel. Approval and reimbursement are subject to applicable organizational policy, confirmation of travel dates and purpose, and submission of required receipts for lodging or other non-per diem expenses. Incomplete forms may be returned and may delay payment.

Personal Information

Full Name Employee ID Address

Phone

Email

Position Information

Job Title Department

Reporting Manager

Manager Phone/Email

Employment Start Date Annual Salary

Travel / Per Diem Details

Destination:

Business Purpose

Departure Date:

Return Date:

Number of Days:

Per Diem Rate (per day): Total Per Diem Requested:

Meals and Other Expenses

Were meals provided by a third party (conference, host, airline, etc.)?

Breakfast provided Lunch provided Dinner provided Lodging Expense (receipts required) Receipt attached for lodging

Mileage and Other Non-Per Diem Expenses

Mileage (personal vehicle): Miles driven at Rate =

Other Itemized Expenses (parking, tolls, taxi, etc.) Total Reimbursement Requested (sum of items)

Employment Record (for HR use)

Prior Employer 1 — Company: Title:

Employment Dates Responsibilities Reason for Leaving

Prior Employer 2 — Company: Title:

Employment Dates Responsibilities Reason for Leaving

Education

Highest Degree Institution Graduation Date

References

Reference 1 Reference 2 Reference 3

Legal Disclosures & Authorization

At-Will Employment Statement: Nothing in this form alters the at-will employment relationship between the employee and the organization. Employment may be terminated by either party at any time, with or without cause, unless otherwise required by written agreement executed by authorized representatives.

Equal Opportunity Statement: The organization provides equal employment opportunities without regard to protected characteristics. All travel and reimbursement decisions are administered consistent with applicable nondiscrimination obligations.

Authorization to Verify: By signing below, the employee authorizes the organization to verify employment record information provided on this form and to obtain and review travel and expense documentation necessary to validate this request. The employee understands that falsification of information may result in disciplinary action, up to and including termination and recovery of funds.

Applicant Certification

I certify that the travel indicated above was for authorized business purposes, that amounts requested are accurate and directly related to the travel, and that I have attached required receipts for lodging and other non-per diem expenses where policy requires receipts. I understand that any advance payment must be reconciled and that improper claims may result in disciplinary action and repayment.

Supervisor / Department Head (Printed Name) Supervisor Approval (select one) Approved Denied Approver Comments

Employee Name:

By:

Date:

What the Employee Per Diem Request Form Is

The Employee Per Diem Request Form is an internal HR finance document employees use to request per diem allowances for travel-related expenses. It establishes the travel dates, destination, daily per diem rate or allocation, purpose of travel, and any required approvals. The form supports consistent reimbursement processing, tax reporting, and auditability by capturing the employee identity, cost center, supervisor authorization, and attestation of eligible expenses. Organizations adapt the form to federal per diem rates or company policy and may require receipts for exceptions or meal allowances beyond per diem limits.

Why a Standardized Per Diem Request Form Matters

A clear form reduces processing time, ensures consistent policy application, and creates an auditable record for tax and compliance purposes.

Typical Users and Approvers

Human resources, payroll teams, and employees initiating travel use the form; supervisors and finance approve reimbursements.

Employees submitting travel reimbursement requests with dates, location, and business purpose.
Supervisors or managers reviewing eligibility and authorizing per diem amounts.
Accounts payable or finance teams validating policy compliance and processing payments.

Clear role definitions on the form speed approvals and reduce follow-up questions between departments.

Core Sections a Professional Form Should Include

A well-structured per diem request form groups identification, travel details, rate calculations, approvals, attestations, and attachments into distinct sections for clarity and auditability.

Employee Info

Full legal name, employee ID, department and cost center so payroll and finance can attribute and code the reimbursement correctly.

Travel Details

Trip start/end dates, city and state, and business purpose to establish eligibility under company and federal per diem rules.

Per Diem Calculation

Daily rate, number of days, partial day rules, and total amount with a clear formula or example for reviewer verification.

Approvals

Supervisor signature, date, and optional secondary finance approval to confirm policy compliance before payment is issued.

Attestation

Employee attestation confirming expenses claimed are for business travel and truthfully reported; include a checkbox and dated signature line.

Attachments

Fields to list and attach supporting documents, such as receipts, itinerary, or RON/notary proof when required by policy.

Step-by-Step: Submitting a Per Diem Request

Follow these steps in order to prepare, approve, and route a per diem request for timely reimbursement.

01

Prepare Form: Complete all required fields and attach itinerary.
02

Calculate Amount: Apply daily rate and partial day rules to get the total.
03

Submit to Manager: Send for supervisor approval with supporting documents.
04

Finance Review: Accounts payable verifies and processes payment.

Typical Digital Workflow Settings

Common configuration choices for online completion and routing reduce manual steps and improve auditability.

Field	Configuration
Auto-route to AP	Enable after manager signs
Required Attachments	Receipt upload when amount exceeds threshold
Conditional Approval	Finance approval for amounts over $500
Retention Tag	Archive with payroll records

How Electronic Submission and Routing Works

Digital forms streamline collection, approval, and storage while preserving an audit trail for each action.

Upload: Employee completes form and uploads attachments.
Sign: Employee and manager apply electronic signatures.
Route: System forwards to accounts payable automatically.
Archive: Signed form and audit trail stored securely.

Digital Platform Considerations

Choose an e-signature and form platform that supports secure storage, audit trails, and required authentication methods.

File Formats: PDF and DOCX accepted
Authentication: Email, SMS code, or stronger
Integrations: HRIS and AP systems

Ensure the platform you select meets internal security policies and any industry-specific compliance needs before broad rollout.

Typical Deadlines and Processing Expectations

Establish clear submission and processing windows to control cash flow and meet tax reporting requirements.

Employee Submission Window:

Within 30 days of travel end date.

Manager Approval:

Within 7 business days of receipt.

Finance Processing:

Processed in next payroll cycle or AP run.

Attach Receipts Deadline:

Receipts required for exceptions within 30 days.

Tax Year Cutoff:

Submit before year-end for calendar-year reporting.

Common Errors That Delay Reimbursement

Missing or mismatched employee ID or name prevents payroll from matching the request to the correct account and delays payment.
Incorrect travel dates or destination can result in using the wrong locality rate and require resubmission for correction.
Failure to attach required receipts for above-threshold items triggers manual review and slows approval cycles in accounts payable.
Using an improper per diem rate or failing to apply partial-day rules leads to calculation errors and potential audit questions.

Risks and Consequences of Incorrect Per Diem Claims

Delayed Payment: Missing data halts reimbursement

Tax Reclassification: Incorrect reporting may be taxable

Audit Exposure: Inconsistent records invite review

Overpayment: Company may recover overpaid amounts

Policy Violation: Employee discipline possible

Recordkeeping Defect: Noncompliance with retention rules

eSignature Pricing and Feature Snapshot for Per Diem Forms

Common eSignature vendors differ on pricing model, trial availability, bulk send, audit trails, HIPAA support, and envelope limits; select based on volume and compliance needs.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	No trial	No trial	Yes, limited	Yes, limited
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently Asked Questions About Per Diem Requests

Answers to common questions about eligibility, documentation, e-signing, and tax treatment when using an Employee Per Diem Request Form.

Need help? Contact support

What qualifies for per diem?
Per diem generally covers lodging, meals, and incidental expenses related to business travel. Company policy may limit eligible items and specify when receipts are required.
How soon must I submit a request?
Submit within your employer's stated window, commonly 30 days after travel ends; late submissions may be denied or require additional approvals.
Can I e-sign the form?
Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA in most states when intent and consent are documented and records are retained.
Do I need receipts?
Receipts are typically required for lodging and for any expenses exceeding per diem thresholds; company policy will specify thresholds and acceptable documentation.
Will per diem be taxed?
Per diem that exceeds IRS substantiated rates or is not compliant with policy may be taxable; consult payroll for tax consequences and reporting.
Who to contact for disputes?
Contact your supervisor or accounts payable for disputes. Retain copies of the signed form and attachments to support any appeal or audit review.

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