US District Court - New Hampshire Travel Expense Worksheet
Case Number: Case Name:
With the exception of tolls, tips, and mileage calculations, receipts are required for all travel expenses as well as all subsistence expenses. Attach copies of all receipts, travel itineraries, schedules, tickets and all funding and/or travel authorization orders. Credit card receipts and billings are not acceptable.
All overnight and all travel by air, bus, or train must have judicial approval. Since the amount allowable is dependant upon place of travel, consult with Clerk's Office CJA Coordinator for specific diem rate or go to www.fedtravel.com
Date
(POV) (mileage only)
Mileage Reimbursement Amount
Tolls / Parking / Public Transportation
Airfare
Hotel
Meals
Taxi / Shuttle
Rental Car
Other
Daily Totals
Page Totals
Total(s)
USDCNH-56D ( 6/09 )