DOT - RTAP TRAVEL AUTHORIZATION

RTAP TRAVEL AUTHORIZATION
North Dakota Department of Transporation, Local Government
SFN 53759 (8-2026)
REQUEST FOR TRAVEL AUTHORIZATION FOR OUT-OF-STATE TRAVEL. Use a separate form for each individual for each trip. Documentation must be provided if airfare costs in excess of the basic least expensive unrestricted accommodations offered. NDDOT only reimburses for allowable costs based on 2 CFR Part 200.474. Send forms to the Transit Section for approval.
Person Traveling (Last Name)
Person Traveling (First Name)
Title
Transit Agency Name
Number of Meetings, Locations, and Days the Person has traveled this Fiscal Year (July 1- June 30)
Destination(s) (City and State)
Date to Depart From Home

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date to be at Destination

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date Event Begins

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date Event Ends

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date to Return Home

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Does trip include vacation hours/days?
Reason for Trip (Agenda must be attached)

Other
Trip Agenda

Cancelof
Name of Meeting or Purpose of Trip (Do Not Abbreviate)

0/500
Total number of persons attending requesting RTAP reimbursement.
Method of Travel
ESTIMATED COST OF TRIP (To Nearest Dollar - Must attach documents for lodging, GSA Per Diem, Hotel Reservations & Registration)
Transportation
Meals
Lodging
Registration
TOTAL
Estimated Cost Attachments

Cancelof
COSTS WILL BE PAID BY
Remarks
Signature of Person Traveling
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
RTAP Director Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: