Form Co 112 PDF Details

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QuestionAnswer
Form NameForm Co 112
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesco 112 state of ct travel authorization form

Form Preview Example

TRAVEL AUTHORIZATION REQUEST

CO-112 REV.7/08

1. Use this form for travel requiring prior approval.

2. For identification of requests, please assign a separate number to each Request form, and enter it under block 2 T.A. Number

STATE OF CONNECTICUT

OFFICE OF THE STATE COMPTROLLER

3. If requesting reimbursement from Union Travel Funds,

 

forward a complete set to the Office of the State

(1) DATE OF REQUEST

Comptroller, Fiscal Policy Division, Travel Unit, 55 Elm

 

Street, Hartford, CT 06106-1775. When Department

 

funded, retain copy for audit purposes.

 

(2) T.A. NUMBER

 

(3) BUSINESS UNIT NAME & ADDRESS TO WHICH FORM SHOULD BE RETURNED (Include Zip Code)

BUSINESS UNIT NO.

TELEPHONE NUMBER (Business Office)

(4)EMPLOYEE NAME (FOR WHOM AUTHORIZATION IS REQUESTED)

(5) EMPLOYEE NUMBER

(6) TITLE

COLLECTIVE BARGAINING IDENTIFICATION

(7) SPECIFY BARGAINING UNIT NUMBER , MANAGEMENT OR OTHER

NP-1 NP-2 NP-3 NP-4 NP-5 NP-6

P-1

P-2

P-3A

P-3B P-4

P-5

MANAGEMENT OTHER (Specify)

(8) WORK TELEPHONE NO. (Include extension no.)

(9) HOME TELEPHONE NO.

(10) OFFICIAL DUTY STATION (Give complete address)

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(11)

ITINERARY

 

(12)

DATES

(13) MISCELLANEOUS INFORMATION (Actual

 

 

 

 

 

 

 

 

time of departure from home and return to

 

HOME

 

 

TO

 

FROM

 

TO

home).

YES

NO

 

 

 

 

Parking Permit Requested?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(14)OBJECT AND NECESSITY OF TRAVEL (Attach substantiating documents)

(15) TYPE OF TRANSPORTATION

AIR

RAIL

STATE OWNED CAR

RENTAL CAR

PERSONAL CAR

(Specify)

OTHER

(16)TOTAL COST (Itemize) NOTE; RATES FOR MEALS AND LODGING SHOULD NOT EXCEED THOSE PROVIDED FOR IN STANDARD TRAVEL REGULATIONS AND IN COLLECTIVE BARGAINING AGREEMENTS.

AIRFARE

 

 

 

 

 

PERSONAL MILEAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LODGING

 

 

 

 

 

(

MI@

 

 

RATE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WITH RIDER:

 

 

 

REFERENCE

 

 

 

 

 

 

CONFERENCE HOTEL

 

 

 

 

 

 

 

RIDER(S) TA #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEALS

 

 

 

 

 

 

TAXI(S)

 

 

 

 

 

 

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REGISTRATION FEE

 

 

 

 

 

(17)

 

 

 

 

TAX

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL COST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRATUITIES

 

 

 

 

 

RAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(18)

(19)

(20)

(21)

(22)

(23)

 

(24)

(25)

 

(26)

(27)

 

 

(28)

 

(29)

(30)

AMOUNT

QUANTITY

GL UNIT

BUDGET

FUND

DEPARTMENT

SID

PROGRAM

ACCOUNT

PROJECT/

CHARTFIELD

CHARTFIELD

BUDGET

GRANT

1

2

REFERENCE

 

.

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

STATE

(31) SIGNATURE OF EMPLOYEE

DATE

 

 

(32) APPROVED BY (Supervisor, Div. Head, Director, Dean etc.)

DATE

 

 

(33) AUTHORIZED BY (Business Unit Head or Authorized Agent))

DATE

 

 

DISTRIBUTION : ORIGINAL- (UNION FUNDS ONLY) - COMPTROLLER'S, FISCAL POLICY DIVISION, TRAVEL UNIT

COPY

- AGENCY BUSINESS OFFICE & EMPLOYEE

 

ORIGINAL - (NON- UNION FUNDS) - AGENCY BUSINESS OFFICE

COPY

- EMPLOYEE

OFFICE OF THE STATE COMPTROLLER

(Authorized Signature/Date)

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This document will need you to enter some specific details; in order to guarantee accuracy, remember to take into account the next steps:

1. Start filling out your Form Co 112 with a number of necessary blank fields. Consider all the information you need and be sure nothing is missed!

Writing section 1 of Form Co 112

2. Once this array of blank fields is done, go to type in the suitable details in these - TYPE OF TRANSPORTATION, Specify, AIR, RAIL, STATE OWNED CAR, RENTAL CAR, PERSONAL CAR, OTHER, TOTAL COST Itemize NOTE RATES FOR, AIRFARE, LODGING, CONFERENCE HOTEL, MEALS, TAX, and GRATUITIES.

Form Co 112 completion process detailed (step 2)

Be very careful while filling in RENTAL CAR and GRATUITIES, since this is the section in which many people make some mistakes.

Step 3: As soon as you have reread the information you filled in, click "Done" to finalize your form. After creating afree trial account here, you will be able to download Form Co 112 or send it via email right away. The PDF document will also be available in your personal cabinet with all of your modifications. FormsPal is invested in the confidentiality of our users; we make sure that all information coming through our tool remains protected.

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