Field Placement Mileage Record BHWET Edith Baker Integrated Healthcare Fellowship

BHWET School of Social Work updated 14-May-19 Mileage Record Student's Name Purpose: Field Placement (University of Pittsburgh to site/ Round trip) Placement:

Field Instructor Signature:

Placement Site Address:_______________________________________________________________ Submit a copy of all monthly mileage records to the program manager with each monthly concur report.

DATE TO/FROM Pitt /Location MILES x Rate TOTAL AMOUNT

I hereby certify that to the best of my knowledge ,the trip information listed on this form is true, correct, and complete.

Student Signature:

B aker Fellows may be reimbursed by the fellowship for mileage if driving 20 miles round-trip or further to and from the University and their field placement sites. Beginning Jan. 1, 2019, the standard mileage rate is .58 cents for every mile. Students are responsible for submitting their own miles into the Concur system, monthly. Submit this signed form with each monthly concur report.

See instructions for the Concur system on the following pages

Concur System: Baker Fellows Mileage Expense Reports

• Log into Concur• Click New• Choose start a report• Report Header

1. Report Name – Your name – Mileage2. Report Date – Current Date3. Business Travel/Report Start Date – First day of travel4. Business Travel/Report End Date – Last day of travel5. Trip Type – Non-Travel6. Traveler User Type – Student Employee7. Report/Trip Purpose – Clinical Rotation/Internship8. Event Name/Business Purpose – Baker Fellowship9. Entity – 0510. Department – 2620011. Purpose – 0000012. Project – 13044613. Reference – 00000

• Are you traveling and receiving a per diem for meals – Click No• Expense type – Mileage Personal Car• Starting Point – University of Pittsburgh• Calculate route – If all travel is in one day choose make a round trip• Transaction Date – Date of travel• Each travel day has to be entered separate but can be on same report• Just repeat starting with Expense type

3/27/2019

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