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[null,null,null,null,null,"State of Nevada"]
[null,null,null,null,null,"TRAVEL EXPENSE REIMBURSEMENT CLAIM"]
[null,null,null,null,null,"(SEE STATE ADMINISTRATIVE MANUAL 0200 FOR TRAVEL REGULATIONS)"]
[]
["Name",null,null,null,null,null,null,"I declare under penalties of perjury that to the best of my knowledge"]
[null,"Last","First",null,"Middle ",null,null,"this is a true and correct claim in conformance with the governing"]
["Traveler ID or Vendor #",null,null," "," ",null,null,"statutes and the State Administrative Manual and its updates."]
[]
["Department & Division"]
["Official Station",null,null,null,null,null,null,null,"Original Signature of Traveler",null,null,null,null,null,"Date"]
[null,null,"City","Section/Unit"]
[]
[null,null,null,null,null,null,null,null,"Original Agency Approval Signature  ",null,null,null,null,null,"Date"]
["Transportation Codes:  Enter appropriate code in Column F"]
["*Original Receipts are required",null,null,null,null,null,null,null,"(Signature indicates verification of Budget/Cat in column C)"]
["  P  -  Plane - copy of itnerary required",null,"X  -  Passenger in Vehicle",null,null,null,null,null,"NOTE:  Agency Approval Signature above indicates there was no "]
["  PP - Private Plane",null,"*PT - Public Trans: Subway, City Bus",null,null,null,null,null,"agency vehicle available and mileage reimbursement can be reimbursed"]
["  PV - Private Vehicle",null,"AV - Agency Vehicle (Motor Pool \n        Leased or  Agency Owned)",null,null,null,null,null,"up to the allowable mileage reimbursement rate for the dates traveled."]
["  *PK - Parking",null,"MP - Motor Pool - copy of MP Dispatch \n        receipt         ",null,null,null," ",null,"Traveler is (check one):"]
["*OT - Other: Limousine, Taxi, Shuttle, Rental Car, Inter-City, Bus, Railroad  ",null,null,null,null,null,null,null,null,null,"Non-State Officer or Employee"]
["*Lodging,  & transportation expenses. ",null,null,null,null,null,null,null," "," ","State Officer or Employee"]
["*Meals for non-state employees including children and foster parents.",null,null,null,null,null,null,null,null,null,"Board or Commission Member"]
[null,null,null,null,null,null,null,null," "," ","Independent Contractor - whose "]
["Miscellaneous Codes:  Enter appropriate code in Column I",null,null,null," "," ",null,null,null,null,"contract provides for travel"]
["*A - ATM Fees",null,"I - Incidental Expense"]
[null,null,null,null,null,null,null,null," "," "]
[]
["A","B","C","D","E","F","G","H","I","J","K","L","M","N","O"]
[" MM/DD/YY","Destination City and Specific Purpose/","Budget/Cat","Travel","Time",null,"Transportation",null," Miscellaneous\n  Expenses ",null,null,"Daily Expenses",null,null,"Total For"]
["Date","Title of Meeting/Training for each trip","Must enter a Budget/Category for each trip","Time\nStarted","Time\nEnded","Code","PC/PP\nMileage","Cost","Code","Cost",null,"Meals Only",null,"Lodging","Day"]
[null,null,null,null,null,null,null,null,null,null,"B: GSA","L: GSA","D: GSA"]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,{"$f":"SUM(J32:N32)+H32","v":0}]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,{"$f":"G35*0.535","v":0},null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
[null,null,null,null,null,null,null,0,null,null,null,null,null,null,0]
["Total of this Claim",null,null," "," "," ",{"$f":"SUM(G32:G59)","v":0},{"$f":"SUM(H32:H59)","v":0}," ",{"$f":"SUM(J32:J59)","v":0},0,0,0,0,0]
["Less Travel Advance Received from the Traveler's Agency or State Treasurer:",null,null,null,null,null,null,null,null,null," "," "," "," ",0]
["Balance Due to Traveler:",null,null," "," "," "," "," "," "," "," "," "," "," ",{"$f":"O60","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null," "]