Travel Authorization Request

TRAVEL AUTHORIZATION REQUEST

Recitals

WHEREAS, the Traveler is required to travel for the performance of official business duties and seeks authorization for travel consistent with applicable company policies and budgetary constraints; and

WHEREAS, the Authorizing Official has authority to approve travel, allocate funds from the designated cost center, and impose conditions on travel to ensure fiscal responsibility and safety; and

WHEREAS, the parties desire to document the scope, estimated cost, payment terms, and conditions for the requested travel.

Requester Information

Travel Details

Purpose of Travel:

Proposed Departure Date:     Proposed Return Date:

Travel Type: Domestic International

Preferred Mode of Travel: Air Rail Personal Vehicle Rental Car

Airfare Class Preference: Economy Premium Economy / Premium Business

Estimated Costs (Itemized)

Scope of Work

Payment and Reimbursement Terms

Estimated Reimbursable Amount:

Late Submission Fee for Expense Claims: — expense reports submitted more than days after return may be subject to reduced reimbursement or denial.

Term and Termination

Authorization Effective Date: .     Authorization Expiration Date: .

Either party may terminate or revoke this authorization prior to departure upon written notice to the other party. Notice to revoke must be provided at least days in advance unless exigent circumstances require immediate revocation.

Confidentiality and Data Handling

The Traveler and Authorizing Official shall maintain the confidentiality of proprietary, personal, or privileged information obtained or created in connection with travel. Traveler will secure any sensitive physical or electronic materials and will comply with applicable information security and privacy policies. Unauthorized disclosure of confidential information may result in disciplinary action and liability for damages.

Compliance and Certifications

By submitting this request, the Traveler certifies that (a) the information provided is true and complete to the best of their knowledge; (b) travel will be conducted in accordance with applicable company travel policies, directives, and any applicable laws and regulations; and (c) all receipts and substantiating documentation for expenses will be retained and submitted in accordance with the reimbursement schedule.

Governing Law

This Travel Authorization Request and any dispute arising under or relating to it shall be governed by the laws of the State of without regard to choice-of-law principles.

Entire Agreement

This document, together with any attachments and approvals, constitutes the entire travel authorization between the Traveler and the Authorizing Official with respect to the subject matter herein and supersedes all prior representations, understandings, and agreements, whether written or oral. Any amendment must be signed by both parties.

Attachments / Additional Instructions

Approval is conditional upon budget availability and compliance with travel policy. Unauthorized travel or expenditures incurred without prior approval may not be reimbursed.

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