Navajo Nation Trip Report

Name of Traveler: TA Number:

Travel Date: (From) (Return) Report Date:

Time of Departure: AM/PM Return Time: AM/PM

Type of Vehicle Used: Tribal Private

Odometer Readings: Beginning: Ending: Total: Miles Incurred

Purpose of Travel: Person(s) Contact: Accomplishments (Note: XVII.2):

*Justification for Unauthorized Expenses:

I certify that this trip report represents all expenses claimed by me while on official travel as stated herein. Signature of Traveler Date Signature of Supervisor