UNIVERSITY OF WISCONSIN-WHITEWATER
REQUEST TO BE ABSENT FROM CAMPUS
Name of Requestor:

CHECK ONE:  
  NON-BUSINESS:
Vacation Dates:
Leave without Pay Dates:
Planned Sick Leave Dates:
     
  BUSINESS:
Travel With Reimbursement for Expenses
Travel Without Reimbursement for Expenses

Itinerary for Business Related Absence:(Include dates/destination/purpose)

             
Account to be charged:   Requested By: Date:
  Org Code   Supervisor Approval: Date:
      Dean or Division Head: Date:
Estimated Expenses:     Dean/Division Head Aproval(signature required or forwarded e-mail for travel with reimbursement for expenses.)
Automobile: $  
Transportation: $  
Meals: $   This form, when approved by supervisor, provides proof that travel status was "in line of duty," and that the purpose was conducting business on behalf of the University of Wisconsin-Whitewater.
Lodging: $  
Registration: $  
Other: $  
Total: $   You are, therefore, exempt from payment of Wisconsin sales and use tax for meals and lodging under s.77.54(9a) Wisconsin Statutes. The University of Wisconsin System is issued a State Tax exempt Number, which is ES4076. You may obtain a sales and use tax exemption certificate from Financial Services.
     
     

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