Travel Authorization Request 1Trip Overview2Disclosure of Outside Activities3Travel Details Request Date* MM slash DD slash YYYY Traveler Name (as stated on driver’s license and/or passport)* First Last Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender (required for ticketed travel)HiddenFrequent Flyer Number (old)Frequent Flyer Number HiddenKnown Traveler Number (old)Known Traveler Number Passport number and expiration (if international travel) HiddenTraveler UFID (old)Traveler UFID* Traveler Email* Traveler Cell Phone Number*Has this travel already been approved by a supervisor or budget authority?*NoYesAll travelers will need to get approval from their supervisor or budget authority before travel arrangements can be made. Supervisor Email* Travel Start Date* MM slash DD slash YYYY Travel End Date* MM slash DD slash YYYY HiddenAre your travel dates flexible? Business Purpose of Travel*Consultation or contractual servicesFundraisingMarketingMeetingProfessional development (other than CE/training)Professional presentationProvide continuing education/trainingReceive continuing education/trainingResearchStudent EducationOtherOtherIf you selected "other," please describe the business purpose of your travelHiddenDestination* City, State; Country if outside US Destination*CityStateCountry (if international, you must complete the insurance form at https://internationalcenter.ufl.edu/travel/online-travel-registration) Trip Purpose* For example: "2021 NAVC Conference" or "2021 Lucky Shelter Consultation"Other This is an urgent request Additional travelers will be traveling under the same trip purpose and destination Additional Travelers Please list additional travelers with same travel and purpose information as above. If traveling for a different purpose (e.g. residents and interns traveling together), please submit a separate request for each.HiddenAre there any special exceptions to UF Travel Policy that should be considered? If so, why?HiddenComments/DetailsIs a third party funding any part of this travel? No Yes Provide estimated total amount and complete Outside Activities Report Are any UF students included in the travel?* Yes No Names of studentsShould travel administrator report student travel to UFCVM? Yes No Has the Clery Act Compliance Travel Portal form been submitted at https://ufl.qualtrics.com/jfe/form/SV_7Qca0NRNGVvs8UR? Yes No Disclosure of Outside ActivitiesDoes this activity match any of the following descriptions?* a - Outside activities in which there is more than an incidental use of university facilities, equipment, and/or services. The completed Disclosure of Outside Activities and Financial Interests form is required to be attached to the Request to use these facilities, equipment or services. b - Outside activities in which a university student or university employee is directly or indirectly supervised by the employee if the employee in any way supervises or evaluates the student or the employee at the University. c - Management, employment, consulting, and contractual activities with, or ownership interests in, a business entity which does business or is proposing to do business with the University. In the cases of material financial and of managerial interests, the information required extends to the spouse and children of the employee, and for managerial interests, to relatives. d - Management, employment, consulting, and other contractual activities with, or ownership interest in, a business entity which competes with the University. e - Candidacy, election or appointment to a public office. f - Required use of books, supplies, equipment, or other instructional resources at the University when they are created or published by the employee or by an entity in which the employee has a financial interest. g - Professional compensated activities, including but not limited to, activities for which travel expenses, travel support, and honoraria are paid, teaching at another institution, or employment as an expert witness. h - Business activities, including service on the board of directors or other management interests or position, with regard to a business entity in the same discipline or field in which the faculty or staff member is employed. i - Any employment, contractual relationship, or financial interests of the employee which may create a continuing or recurring conflict between the employee's interests and the performance of the employee's public responsibilities and obligations, including time commitments. This includes any outside activity in which the employee is required to waive rights to intellectual property. j - Outside activities and financial interests required to be reported under certain federal contract and grant regulations. Such disclosures may also need to be made at the time of the submission of the proposal. k - Outside activities (employment, consulting, management and other contractual activities) and financial interests in an entity that supports the employee’s research or training activities in any way. l - Outside activities (employment, consulting, management and other contractual activities) and financial interests in an entity that licenses technology invented by the employee. m - Any other employment outside the University. n - Any other outside activity or financial interest required to be disclosed under University Regulation 1.011. To the best of my knowledge, this activity matches none of the above descriptions. Travel DetailsFunding Source (please provide flex code if known)* MSMP grant MCC Donations/gifts/UFF Research Contract Supervisor will assign fund source Other If "Other," please describe the funding source Travel Cost EstimatesPlease provide estimates for the expenses you expect to incur for this travel. Only general estimates are needed.Event Fees (if applicable)Hotel / Lodging If you have not yet selected a hotel, basic estimates for lodging based on location are available at www.gsa.gov/perdiem. This link opens in a new window. You may also use a general estimate of $100 per night.Meals(Per diem: Breakfast: $6, Lunch: $11, Dinner: $19, Full day: $36; meals are not reimbursable if included in event)Travel start dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Travel start time : Hours Minutes AM PM Travel end dateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Travel end time : Hours Minutes AM PM FlightYou can find a general estimate from Kayak. This link opens in a new window. Baggage feesLocal transitParkingVehicle rental($35 per day is an acceptable general estimate for state-rate rental of a subcompact vehicle)Fuel for rental($35 for a tank of gas is an acceptable general estimate for one week with a rental car)TollsPersonal vehicle mileage(0.445 cents/mile)There are no costs to be paid with UF funds TotalTravel ArrangementsBooking* I will make my own travel arrangements and submit receipts for reimbursement Please assist with booking travel Special dietary/accommodations instructions I do not need any travel assistance or payment arrangements before the trip (reimbursement will be requested after trip) Special dietary/accommodations instructionsEnter any additional requests or instructions for booking travel.Booking Requests Hotel: Free internet Hotel: Breakfast Hotel: Near address (see other considerations) Multi-leg Trip Flight booking instructions Car rental instructions Hotel booking instructions Other Considerations Booking: Other considerationsEnter any additional notes for booking travel.Flight booking instructionsCar rental instructionsHotel booking instructionsHiddenSelf-booking detailsIf you already have tentative arrangements or reservations, please provide information.CommentsSubmitted by Someone other than the Traveler is completing this form HiddenRequester Name First Last HiddenRequester Email Emergency Contact InformationEmergency Contact Name First Last Emergency Contact PhoneEmergency Contact Email Additional Information (If Necessary)Comments or More DetailsUse this space to provide more details or an additional explanation of your travel request as needed.