MOVING EXPENSES SUPPORT FORM FORM INSTRUCTIONS
Systems and Procedures
A Division of The Corporate Controller's Office
IN

MOVING EXPENSES SUPPORT FORM
FORM INSTRUCTIONS

Form Instructions

  1. Enter Special Request for Check (SRFC) document number.
  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 more 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. For 2019 the mileage reimbursement rate is 20 cents.
  15. This is a calculated field. No entry necessary.
  16. Enter the total dollar amount spent on meals during move from old location to new location.
  17. Please specify Other forms of transportation (i.e., air, car rental, etc.).
  18. Enter the total amount spent on other forms of transportation during move from old location to new location.
  19. Enter the beginning date for storage of household and personal effects.
  20. Enter the ending date for storage of household and personal effects (not to exceed 30 days).
  21. Enter the total amount spend on storage.
  22. Add any additional notes, as needed.
  23. Total Paid to Employee - This is a calculated field. No entry necessary.
  24. Total Paid to 3rd Party - This is a calculated field. No entry necessary.
  25. The individual requesting reimbursement must sign the completed form.
  26. The individual requesting reimbursement must date the completed form when signing the form.

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

Image of Exhibit A - Moving Expenses Support Form