Instructions of Preparation of CSD4 form
Each numbered item refers to the corresponding item number on the Expense Reimbursement Claim Form
- Name of employee.
- If warrant is to be mailed, fill in complete address. If warrant is to be sent to the department, leave this item blank.
- Name of the department submitting claim.
- Date claim prepared.
- Fill in the fund number, department number, and expenditure codes. Also note voucher numbers.
- Enter date of each trip and/or expense incurred.
- Enter the destination. Whenever applicable, enter the purpose of the trip. If a travel request is required, enter the travel request number.
- Transportation (automobile)
(See County Travel Policy).
Actual amount of each meal. (See County Travel Policy).
This column is to be used for miscellaneous expenditures such as parking, business telephone calls, registration fees, toll bridge fares, etc. Also use this column for the fixed mileage reimbursement for bridge and ferry tenders who are not in residence.
Compute mileage amount by:
- If a private car is used, enter the total number of miles for each trip. Do not use fractions of a mile.
- If public transportation such as airplane, train, bus, taxi, etc. is used, enter the dollar amount. (See County Travel Policy).
Add total amounts per item numbers 8,9, 10, 11 & 12 and enter this amount in column No. 13 "Total claim amount" line. If you received a travel fund advance, submit your claim to the County Administrative Office. He will enter the travel advance amount, and the amount to be reimbursed to the employee, and will forward the claim to the County Auditor for processing.
To be signed by employee incurring expenses.
- Multiplying number of miles from column No. 8 times applicable rate.
- Enter this amount, or if you are authorized a minimum monthly car allowance, enter the larger of the two amounts in the "Total mileage amount column". (See County Travel Policy).