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Per Diem Justification Form

Per Diem Justification Form

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Financesign

This Per Diem Justification Form is required only when the travel lodging/hotel nightly rate(s) exceed the GSA Per Diem Rates for both employee and non-employee travelers. This form must be completed prior to the travel departure date, by the employee-traveler or their Proxy, or by the Net-Cardholder-on behalf of the student or non-employee traveler.

Once submitted, you will receive an acknowledgement email. The School's Finance/Procurement team will then electronically sign the form and a PDF fully executed copy of the form will be automatically emailed to you-to download and attach to the CUNYfirst Travel Authorization and/or Travel & Expense Report, or the Net-Card CUNYfirst reconciliation-if this travel lodging/hotel is for students and/or non-employees.

Please review all instructions and notes embedded in this form.

Traveler’s Name:(Required)

Email(Required)

(Note to Proxies and Net-Cardholders: If you are a proxy submitting this form on behalf of the employee-traveler, or if you are a Net-Cardholder submitting this form on behalf of a student or non-employee traveler, please enter the proxy's or Net-Cardholder’s email in the field below, and not that of the traveler. This will ensure that a signed PDF copy of this form will be automatically sent to the Proxy's or Net-Cardholder's email).

Travel Start Date(Required)

Travel End Date(Required)

Destination (City/State):(Required)

Name of Hotel:(Required)

GSA Per Diem Rate:(Required)

Click here for GSA Per Diem Rates for the location you are traveling to and enter in the field below.

Actual Lodging/Hotel Rate:(Required)

Enter in the field below the lodging/hotel's rate(s) per night before taxes. If nightly rates vary, please enter only the highest nightly rate that exceeds the GSA Per Diem Rate listed above.

Please authorize the hotel rate which was higher than the allowed per diem rate because (check one):(Required)

The hotel is where the conference was held, saving additional transportation expenses. (Note: This option may only be selected if the combined cost of the least expensive hotel in the conference area plus the cost of transportation to and from the official conference hotel exceeds the cost of staying at the conference hotel itself).

The hotel was the least expensive hotel in the conference area (attach three quotes for documentation).

It was the only hotel available in the conference area.

The hotel had a discounted rate, negotiated and suggested by the conference.

Other

Traveler Printed Name(Required)

(Note to Proxies and Net-Cardholders: If you are a Proxy or Net-Cardholder submitting this form on behalf of the traveler, please enter the traveler's name in the field below and not that of the Proxy or Net-Cardholder.

I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

Date:
MM slash DD slash YYYY

Approval Date
MM slash DD slash YYYY

Finance Department Printed Name:(Required)
I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

Finance Department Signature:(Required)
I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document.

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Per Diem Justification Form

Per Diem Justification Form