OEA Event Mileage Only Reimbursement Form- 1/2 IRS Rate

Expense Reimbursement Request should be submitted within 30 days including all receipts and documentation (if applicable). Direct Deposit will be used if on file. Please reach out to AP@oregoned.org to set up direct deposit, if desired.

Event/Activity
Date of Event/Activity Date of Event/Activity / MM / DD YYYY
Location of Event
Local (Please no abbreviations)
Payee Name Payee Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Reimbursement Expenses

Please add your expenses here- all receipts must be provided for this reimbursement request.
Please note eligible expenses and reimbursement calculation may be dependent on bylaws and applicable guidance. This includes mileage reimbursement, meals and lodging. See below for other expenses.
Date Date / MM / DD YYYY
Mileage Expense Reimbursement
Please add mileage reimbursement expense here

Travel expenses shall be reimbursed for those members who travel more than 100 miles total, at the rate of 35 cents ($0.35) per mile, plus 2 cents ($0.02) per mile for each additional member passenger. (Please list names of member passengers below.)
Mileage - To Event
Mileage - From Event
Mileage - Round Trip
Is the member transporting passengers?

Is the member transporting passengers? Yes No
Select Number of passengers
Passenger 1
Passenger 2
Passenger 3
Passenger 4
Passenger 5
Total Mileage Reimbursement $.35 per mile + $.02 per mile per passenger $ Dollars . Cents

OEA Event Mileage Only Reimbursement Form- 1/2 IRS Rate

OEA Event Mileage Only Reimbursement Form- 1/2 IRS Rate

Reimbursement Expenses

Mileage Expense Reimbursement Please add mileage reimbursement expense here

Mileage Expense Reimbursement
Please add mileage reimbursement expense here