REIMBURSEABLE RELOCATION EXPENSES WORKSHEET



Reimbursable Relocation Expense |Maximum Allowable Reimbursement |Reimbursement Notes | |Estimated Employee Expense |Actual

Employee Expense | |Travel Reimbursement (in accordance with RPM 11.08 Travel Policy) | |

|En Route Travel by Air for employee |Coach Airfare |If | | |

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|Per diem (lodging and meals & |Day 1 – Day 30 (including travel en route to new location) |For| | |

|incidental expenses (M&IE)) en route |Per diem (lodging plus M&IE (meals and incidental expenses)) |tem| | |

|at new work location and temporary |75% reimbursement for first and last day of travel for the employee |por| | |

|lodging at new work location up to 30|100% reimbursement for travel in-between the first and last day of travel for the |ary| | |

|days |employee |liv| | |

| |50% of the applicable M&IE is reimbursed for the first and last day of travel for |ing| | |

|Reimbursement rate for M&IE are |immediate family members age 12 or older |exp| | |

|determined by the new work location. |75% of the applicable M&IE for in-between the first and last day of travel for |ens| | |

| |immediate family members age 12 or older. |es | | |

| |37.5% of the applicable M&IE is reimbursed for the first and last day of travel for |gre| | |

| |children under age 12 |ate| | |

| |50% of the applicable M&IE for in-between the first and last day of travel for |r | | |

| |children under age 12. |tha| | |

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|Shipment of personal effects (including clothing and luggage) |

|Temporary Storage of Household Goods |

| |

|Associated Miscellaneous Relocation |$1,000 with documentation | | | |

|Costs |Automobile registration | | | |

| |Drivers license and use taxes | | | |

| |Cutting and fitting of rugs, draperies and curtains | | | |

| |Forfeited utility fees and deposits | | | |

| |Purchase of insurance against damage to or loss of personal property while in transit| | | |

|Sale of former residence |

|Purchase of New Residence |

|Employment Assistance to Spouse (Domestic Partner) | | | |

|Maximum Total Approved Reimbursement: | | | |

|Difference | | | |

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