MOVING EXPENSES SUPPORT FORM
FORM INSTRUCTIONS

Form Instructions

1. Leave this field blank - the individual entering the transaction in SIMBA or SAP Concur will complete this field
2. Enter Name of the individual requesting reimbursement
3. Enter the Penn State University ID number
4. Enter the "moving from" location including City, State/Country
5. Enter the "moving to" location including City, State/Country
6. Enter Total amount paid by you for the transportation of Household Good and Personal Effects
7. Enter Total amount paid by you to 3rd party (i.e., moving company, truck rental) for the transportation of Household Good and Personal Effects
8. Check Box must be checked if move is less than 50 miles further than current commute
9. Enter the departure date for move from old location to new location
10. Enter the arrival date for move from old location to new location
11. Enter the number of nights lodging for move from old location to new location
12. Enter the total dollar amount spent for lodging during move from old location to new location
13. Enter the total number of miles accumulated on your personal vehicle during move from old location to new location
14. This is a calculated field. No entry necessary
15. Enter the total dollar amount spent on meals, up to the per diem limit for the location, during move from old location to new location
16. Please specify Other forms of transportation (i.e., air, car rental, etc.)
17. Enter the total amount spent on other forms of transportation during move from old location to new location
18. Enter the beginning date for storage of household and personal effects
19. Enter the ending date for storage of household and personal effects (not to exceed 30 days)
20. Enter the total amount spent on storage
21. Enter the beginning date of temporary housing
22. Enter the ending date of temporary housing (not to exceed 30 days)
23. Enter the total amount spent on temporary housing
24. Add any additional notes, as needed
25. This is a calculated field. No entry necessary
26. This is a calculated field. No entry necessary
27. The individual requesting reimbursement must provide either a hand-written siganture or provide their digital ID
28. If an hand-written signature is provided, enter the date the form was signed. If a digital ID provided, skip this field

Receipts are required for all reimbursed expenses except meals (up to the per diem limit for the location) and personal mileage.

Version A - Moving Expenses incurred between January 1, 2022 and June 30, 2022:

Version B - Moving Expenses incurred between July 1, 2022 and December 31, 2022: