Travel Information - Contingent Fund Request

University of Wisconsin System
CONTINGENT FUND REQUEST
University of Wisconsin-Platteville

Date

Receipt is hereby acknowledged for the sum of $

Purpose

Destination

Date of Departure

Date of Return

Account Code

The University may deduct the amount of this advance or the unused portion thereof from my salary if I do not provide an accounting of my expenditures within seven days after ending date of my trip.

Payee Name

Payee SSN