Skip to form

BOX ELDER COUNTY

noreply@boxeldercounty.org

1 SOUTH MAIN STREET, BRIGHAM CITY, UT, 84302, US

435-734-3300

SeamlessDocs

The Trip Request Form is to be used when requesting per diem and/or mileage reimbursement ahead of your trip. You may bypass the Trip Request Form and only fill out the Trip Expense Report if you do not wish for a cash advance. The Trip Request Form needs to be completed by Tuesday prior to the week of travel and will come in the form of a check you will need to cash. A trip expense report always needs to be filled out following a trip regardless of whether a Trip Request Form was completed. This also means that beginning in 2018, no food for overnight trips should be charged to your purchasing card.

Please note, that in order to allow for proper submission, you need to click the Submit & Sign button for signing the document rather that clicking the Signature Here box directly. After your signing, you also need to then enter your department head name and email so that the document can be forwarded to them for signature. For nonelected directors, this would mean the commissioner over you. Elected Officials will forward the document to themselves for signature as Department Head knowing the Auditor's Office will be reviewing for accuracy. Please do not bypass this step or it will be declined by the Auditor's Office.

Thank You!
Please check that you agree before continuing.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.
Signature HereClick to Sign
04/26/2024Click to Sign
Signature HereSigner2 Will Sign Here
04/26/2024
04/26/2024Click to Sign
Signature HereShirlene Larsen Will Sign Here
04/26/2024

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.

x

Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue

x

Additional Signatures Required

Please upload conference or training agenda along with any google map for mileage as one scanned pdf document.

Please upload the following attachments:

There is a 250MB limit on each attachment.

Travel Agenda (2) Click Here to Upload