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Welcome to the KyANA Reimbursement Form. If you have any questions please contact Autumn Phelps

  • Submit within 30 days of travel.
  • Only submit reimbursement up to the maximum amount that’s been allotted  for each meeting.  In most cases your largest expenses (flight, hotel, registration) will exceed the cap so you won’t need to submit any meal receipts.
  • Each submission on the form should match each receipt total.  For example, if you remove a portion of the meal (alcohol) from being reimbursed, be sure to indicate it on the receipt by circling, crossing out, etc. and make sure that the totals are the same when that item is subtracted.
  • Submit actual receipts, screenshots or line items from a credit card statement aren’t enough as this causes the potential to be subject to 1099 reporting and having to report on your taxes.
  • If you book your flight through Altour, remember to subtract that amount from your allotted amount before you submit for reimbursement.
  • If you are submitting mileage, please include a map which shows your departing and arriving locations which shows the estimated number of miles.
Your Name(Required)
Who should the payment be made out to?
What was the purpose of this trip or the reason for this reimbursement. IE did you travel to the 2022 conference.
Address(Required)
Expenses
You can enter up to 20 expenses on one form.

If entering an expense as other you must enter your reason in the notes field near the bottom of the form.

Date should be entered as month/day/year - example - 07/10/21 or 07/10/2022
Expense Type
Amount
Date
 
Use The + Symbol to add more than one entry.
Mileage Tracker
Mileage (Only enter miles if not inputting gas receipts and/or rental fees).

You can enter up to 10 mileage entries below. More if you use Trip Count.

Please only use whole numbers for number of miles. Round Up to the next whole number (45.5 miles becomes 46 miles)

Route Name This is just a name for the trip. Say you drove from your house to the hotel. You would put something like Home to Hotel or Home to Conference in the route name.

Trip Count: Say you took the same route with the same mileage 5 times. Rather than enter that info 5 times, trip count allows you to enter that trip once then we multiply the miles by the trip count to get your total miles.
Route Name
Mileage
Trip Count
Total Miles
 
Use The + Symbol to add more than one entry.
Please upload support for each expense (including route map for mileage). Please submit all receipts in one file when possible. If missing a receipt please let us know in the notes field below.
Drop files here or
Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 5 MB, Max. files: 10.