2.125-E2 Board Member Estimated Expense Approval Form

Submit to the Superintendent, who will include this request in the monthly list of bills presented to the School Board. Use of this form is required (1) by 2:125-E3, Resolution to Regulate Expense Reimbursements and (2) for pre-approval of expenses to be charged to a federal grant or State grant governed by the Grant Accountability and Transparency Act. Please print.

Name: Title/Office:

Travel Destination: Purpose:

Departure Date: Return Date:

☐ Estimated Expenses Approval Requested (50 ILCS 150/20 or grant expenditure)

☐ Travel is grant-related* (specify grant):

☐ Purchase Order Requested Purchase Order #:

☐ Expense Advancement Voucher Requested (105 ILCS 5/10-22.32)

Voucher Amount:

Estimated Expense Report
Auto Travel Allowance: per mile *Grant-related travel only: Except for mileage and other transportation expenses, expense reimbursement/per diem is only allowed if on official travel status for 12 hours or more. If lodging at or below the applicable rate cannot be identified, please indicate below and attach at least three quotes for review.
Date	Auto Mileage Miles Cost	Transp. Expenses	Lodging	Meals or Per Diem Bkfst Lunch Dinner	Other Item Cost	Daily Total






Total							$

Submitting Board Member’s Signature Date

Superintendent Signature Date

School Board Action: ☐ Approved ☐ Denied

☐ Approved in Part ☐ Exceeds Maximum Allowable Amount

☐ Grant Funding Source (if applicable):

Comments:

Updated: June 2024