Per Diem Request

How it Works

Your manager will pre-approve per diem and notify payroll before you travel.
You will submit this form after you travel.
Your per diem will be added to the next payroll that is processed after approval and form is received.
If form does not match pre-approval, Payroll will seek approval from managers.

Employee Name(Required)

Employee Number(Required)

Start Date(Required)

End Date(Required)

Requested Number of Per Diem Payments (1 per night)(Required)

Location / Destination of Work (City and State)(Required)

Job Number(Required)

Business Purpose of Travel(Required)

Per Diem Payout Option (non-taxable)(Required)

Manager (enter your direct manager's name)(Required)

Notes / Comments(Required)

Date Submitted(Required)

BE SURE TO INCLUDE: ALL INFORMATION ABOVE & COMPLETE JOB NUMBER (including letters).

PER DIEM REQUESTS MUST BE MADE WHEN TIME IS SUBMITTED.

IF PER DIEM REQUESTS ARE NOT MADE WITHIN 14 DAYS OF TRAVEL, THEY WILL NOT BE PAID.