Annual Meeting Travel Reimbursement

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Annual Meeting Reimbursement Form

Seated delegates may request reimbursement for eligible travel and hotel expenses paid to attend the annual business meeting of the ACA House of Delegates at ACA Engage. Eligible expenses will be reimbursed up to $1,000. The requirements for eligibility and the reimbursable expenses are described in the annual meeting guide (PDF).

Meeting and Contact Information

Meeting Name(Required)

Please list travel and hotel expenses associated with attendance as a seated delegate.

Meeting Date(Required)

Name (First, Last)(Required)

Address(Required)

City(Required)

State(Required)

ZIP Code(Required)

Email Address(Required)

Mobile Phone(Required)

Travel Expenses

Total Taxi/Uber/Lyft Fares(Required)

Enter "0" if none.

Total Airport / Train Station Parking Fees(Required)

Enter "0" if none.

Air / Train Fares(Required)

Enter "0" if none.

Miles Traveled (personal vehicle)

Enter the mileage traveled to/from airport, train station, etc.

Mileage Fee

Amount based on the mileage entered in the previous field. IRS current reimbursable rate is $0.76 per mile.

Travel Expenses SUBTOTAL

Hotel

Hotel Nights (number)(Required)

Please enter a number from 0 to 6.

Enter "0" if none.

Hotel Fees(Required)

Enter "0" if none.

Hotel SUBTOTAL

The travel stipend is considered taxable 1099-Miscellaneous income by the IRS. You will recieve a 1099 form for this at year end.

Donations To:

ACA-PAC

Please enter a number from 0 to 100000.

NCLAF

Please enter a number from 0 to 100000.

Donations SUBTOTAL

This amount will be deducted from your total reimbursement.

GRAND TOTAL

Total Expenses

Expenses minus donations

Attach Receipts

Drop files here or

Accepted file types: pdf, png, jpg, jpeg, gif, Max. file size: 10 MB, Max. files: 10.

Please include receipts for all expenses.

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