ORGINAL TO

ACCOUNTING UNIVERSITY OF RHODE ISLAND FOR ACCTG. USE ONLY

REV. 03/10 TRAVEL EXPENSE VOUCHER Due Date
VO#
DATE 9/17/2010 TAR# FUND/DEPT/PROG/PROJ $
FUND/DEPT/PROG/PROJ $
EMPL ID NAME Yogi Kurniawan

HOME MAILING ADDRESS: DEPT. TELE # 874-2655

P.O. BOX/STREET 2900 Kingstown Road Apt A111 TITLE Grad Student
CITY/STATE/ZIP Kingston, RI 02881 DEPT./DIV. Chemical Engineering

PURPOSE OF TRAVEL: AICHE MEETING IN BOSTON DATE OF: TIME OF:

Attended DEPARTURE 9/16/2010 DEPARTURE 3:35 PM
ARRIVAL 9/16/2010 ARRIVAL 10:15 PM

AUTOMOBILE TRAVEL

CAR REGISTRATION # 955825 MAKE/MODEL/YEAR Mazda/Protégé/ 2003

AUTO INS. CARRIER GEICO AUTO POLICY EXP DATE 3/15/2011

ODOMETER READINGS: Mileage

Date To From Start End Totals Amount
9/16/2010 Billerica, MA Kingston 103691 103871 180 $99.00

TOTAL 180 $99.00

OUT OF STATE TRAVEL

Misc. (Tolls, Parking, Taxi, etc.)
Date From/To Per Diem Hotel Airfare/Auto Item Amount Totals
9/16/2010 Kingston/Boston Registration $20.00 $20.00
$-
$-
$-
$-
$-
$-
$-
$-
$-
$-
$-
TOTAL $119.00
LESS CASH ADVANCE
LESS PAYMENTS ON URI TRAVEL CARD
LESS PAYMENTS ON P- CARD

TOTAL TO BE REIMBURSED (OR DUE URI) $119.00

I hereby certify that throughout the above dates I have maintained a valid operator's license and my vehicle has been
registered and insured; that the above mileage is correct and was incurred for official state business. That the travel from my
residence was shorter than the travel between my official station and the destination; that this travel expense complies with the
state travel regulations and that the total listed above is a proper charge against the State of Rhode Island.

FOUNDATION FUND APPROVAL TRAVELER'S SIGNATURE

GRANT FUND APPROVAL DATE
CHECK NUMBER APPROVAL SIGNATURE
CHECK DATE CONTROLLER'S OFFICE PRE-AUDIT