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APPENDIX H MILEAGE TRAVEL LOG Grant No. PSC-20-___ Period of Travel From: ________________ To: _______________ Employee: _____________________ Please complete all fields for each trip. Destination must include street address & city. TRAVEL DATE TRAVEL TIMES TRIP ODOMETER READING DAILY TOTAL MILEAGE (Daily Total x .440) RENTAL CAR (See Expenditure Guidelines for OVER NIGHT STAY (YES/NO) I certify that all mileage reported was driven for official MEAP grant business only. START END START END equal to miles traveled x .440) Starting Location (Complete Address)/ Ending Location (Complete Address) REASON FOR TRAVEL 1/1 6:00 AM 8:30 PM 11125 11140 440 193.6 $250 Yes Meeting
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0 0 To and From Locations AUTHORIZED (Signature) TOTAL: GRANT 0 0 0