State of Florida



|State of Florida |Payee (Typed) ___________________________________________ |Headquarters __________________________ |P.O. # _______________________ |

| | | | |

| |Address ___________________________________________ | | V # _______________________ |

|Voucher for Reimbursement | | | |

|of Traveling Expenses | ___________________________________________ | | |

|x out of state | |Travel Performed from Point of|Purpose of |Hour of Departure and |

| | |Origin to Destination |Reason |Hour of Return |

| |Date | |(Name of | |

| | | |Conference) | |

|Payee Signature ____________________________________________________________________________________ Less Class C Meals $ -________________ |

| |

|Date Prepared _________________________ |Title ___________________________________________________ Total Expenses Claimed $_________________ |

|Supervisor Signature _________________________________________ |Date ________________ |Fund |Function |Object |Cost Center |Project |Amount |

| | | | | | | | |

|Superintendent Signature ______________________________________ |Date ________________ | | | | | | |

| | | | | | | | |

O-FI-05

Rev 07/12/11

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