Reimbursement Form

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Definitions


A long-term stay refers to a stay of 30 or more consecutive days within a visitor’s invitation dates during which the visitor visits the Simons Institute. 

 

A short-term stay refers to a stay of fewer than 30 consecutive days within a visitor’s invitation dates during which the visitor visits the Simons Institute. 

 

Per diem reimbursements are for long-term stays, and should be submitted after every 30 consecutive days (including weekends) you work at the Simons Institute. These reimbursements do NOT require receipts.

 

Travel reimbursements are for both long-term and short-term stays, and should be submitted only AFTER you return home from the Simons Institute. These reimbursements require receipts and itineraries for any airfare claim, and receipts for all individual transactions of $75 or more.

 

Travel & accommodation reimbursements are for short-term stays, and should be submitted only after you return home from the Simons Institute. These reimbursements require receipts for any lodging claim, but do NOT require receipts for meals and incidentals.


Relocation expenses are for Simons Berkeley postdocs only. These expenses require receipts and itineraries for any airfare claim and receipts for all individual transactions of $75 or more.



Reimbursement timeline

 

Since all reimbursements are audited by several different departments on campus, no concrete timeline can be given. Historically it takes from 1 to 2 months from the time you submit the form to the time payment is released, but there are outliers on both ends. In order to minimize delays, please do your best to provide receipts with clear proof of payment. If you think that additional documentation, such as a credit card statement, may be necessary, please feel free to upload it along with your receipts. 

 

Here are some common sources of delays:

  1. Flight tickets with dates that are more than 24 hours outside invitation dates
  2. Flight tickets that are not roundtrip from your home
  3. Driving to Simons and claiming mileage without prior written approval from Peter Bartlett
  4. Receipts not in English with no supplemental comments

 

If any of these points apply to you and you did NOT get prior approval from Peter Bartlett, please contact me at simons-reimbursements@berkeley.edu as soon as possible.


Personal Information




Phone number, starting with area code

Please enter your home address. Do not use your temporary Berkeley address.





Trip information



Reminder:  You will need to provide valid itemized receipts for all expenses ≥$75, as well as for all lodging, rental car, and airfare expenses. Airfare expenses will also require an itinerary and seat class. Only coach/economy (including variants like economy-plus and economy-premium) can be reimbursed without prior approval.





Travel documents include PR card, Passport, Visa page, Visa stamp, I94, and W8BEN.


Click "Add another response" if you need to upload more than one document.

Click "Add another response" if you need to upload more than one document.
Example Image of Visa Stamp
Sample Visa Stamp

select all that apply

select all that apply

Travel Reimbursement

Travel expenses


Select a date

24 hour time (e.g. 06:30 or 14:45)


Select a date

24 hour time (e.g. 06:30 or 14:45)


$


$


Driving expenses

Please note that if you did NOT create a mock-flight itinerary before you drove, one will be created by the UC Berkeley travel department. You will be reimbursed the lesser of your request or the flight comparable, up to the max stated in your invitation letter.


$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.

Private car expenses





$


Other driving expenses


$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.


$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.

Additional ground transportation


$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.

Enter each taxi ride separately.
$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.
$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.


$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.



$
Please convert amounts in foreign currencies to US Dollars (use date of purchase). You can convert foreign currencies at http://www.oanda.com/currency/converter.

For example, a taxi ride to your home airport costing $84.


$

Per Diem Reimbursement


Default reimbursement



$
Cannot exceed the amount specified in your offer letter.


$
Custom reimbursement
Monthly per diem expenses


Actual expenses in USD:
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Meals & Accommodation Reimbursement

Please note: due to campus policy, total meals expenses cannot exceed $62 per day and total daily expenses cannot exceed the funding listed in your invitation letter. This will be capped based on the funding listed in your invitation letter.
Date Lodging cost per night in USD Breakfast Lunch Dinner Meals total Daily total



$

Relocation Reimbursement

Provide a description and amount for each relocation expense. Receipts are required for all expenses of $75 or more.
Description Amount


$

Summary

$
$
$
$
$
$

Please note whichever payment method you choose, it needs to be set up with our reimbursements specialist prior to submitting your reimbursement form.

Questions? Contact Kelsey Larsen at +1 510.664.4029 or simons-reimbursements@berkeley.edu.

Signature required: Your reimbursement request is not complete until it has been electronically signed on the next page. If the e-signature page does not appear, please contact Kelsey Larsen.
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