Fill in areas enclosed by bold lines.
Ritsumeikan Statement of Travel Expenses (for students and persons outside of the
University) Front Side
The application below is for a person outside the university who will take a business trip required for a research activity of this university.
Date of Application
MM
DD
YYYY
Research representative/research
partner
Seal
(Researcher of this university with authority to
disburse budget funds)
Name
Seal
If employed at research institution,
etc.
Date of Birth
MM
Affiliated unit
(Research institution)
DD
YYYY
Job title
Person Making the Business Trip
Need Request for Business Trip?
(Check applicable box to right.)
If undergraduate/graduate student

Please issue to affiliated research institution.

Issuance not necessary.
University
Dept./Graduate School
Year of
Study
TEL
Home
address
E-mail
"Departure station" for travel expense
calculation
(Check applicable box to right, and enter name
of railway company and station.)

Station closest to affiliated research
institution

Station closest to home
Railway company:
Station:
Bus company:
If bus connects from your affiliated research institution or home to aforementioned
"departure station", enter name of bus company and bus stop. *1
Bank Account
Name of the
Bank
Bank
Bus station:
Name of the
Branch
Branch
Furigana
Account Number
Ordinary/Checking
Account
Holder Name
Period
From
Schedule
MM/DD/YYYY
to
Destination*2
MM/DD/YYYY
Place of work
(
nights
days, including
nights in vehicle, etc.)
Description of work
/
/
Action Plan
/
/
/
/
/
*1 However, if the one-way railway use segment from the "departure station" to the "station closest to the business destination" is less than 70 km, the bus fare to the
"departure station" will be paid.
*2 For a domestic business trip, enter the prefecture and municipality; and for an overseas business trip, enter the country and city.
Research Division Form 2-3, April 2015 Version
Fill in areas enclosed by bold lines.
Statement of Travel Expenses Reverse Side
(Materials that confirm destination, schedule, content of business, and other details
of business trip plan [please attach])
If you will engage in multiple business activities in a single business trip, this is required
for each activity/objective.
Name of the person making the business trip
Discussion, interview, etc.
Appointment e-mail, letter of request, etc. (that confirms date/time, location, etc.)
In action plan space on front side, describe in detail in 1-day units. If entry space is insufficient, create separate
Material gathering, fieldwork, etc.
sheet (form optional).
Event information, website screenshot, etc. (if presenter, submit your name, date/time, and other confirmable
Academic conference, workshop, etc.
details)
[Spending budget] * Write in the name of the research representative below if the budget type is one of the following: Grant-in-Aid for Scientific Research, Strategic
Research Foundation Grant-aided Project for Private Universities, and Joint Research such as the System for Promotion of Research Institutes.
Strategic Research Foundation Grant-aided Project for Private
University Business
Universities
Research Travel Allowance
(
Office)
(Project Name
)
Research Environment Enhancement
Individual Research Material
Grants-in-Aid for Scientific Research (GASR)
Funds
Allowance
Grant for
Grant for General
Program to Support General
Provision of travel expenses not
New Academic
Challenging
Research Activities
Research Activities (Kibannecessary
Areas
Exploratory
(Kiban-kenkyu)
kenkyu)
Research
(
)
Grant for Research
Start of
Program for Application of the
Grant for JSPS
of Young Scientists
Delegated Research/Joint
Research
Grants-in-Aid for Scientific
Fellows
(Wakate-kenkyu)
Research/Contributions for Encouraging
Research (KAKENHI)
Activities
(
)
Research
(
)
[Share of the
Program for Promotion of
Other (
)
International Research
Grant-in-Aid]
Affiliation of Representative:
Item:
Other External Funds (
)
Other Internal Programs (
)
Name of the Research Representative*
[Notes to Office] Supplementary explanation regarding material that confirms business trip plan
[Reason for previous/following night
accommodation application]
[
] → If it is necessary to depart from the departure station or station closest to your
residence before 7 a.m., payment will be made for the previous night's
accommodation.
] → If you arrive at the departure station or station closest to your residence at 10
p.m. or later on the day of a business trip, payment will be made for that night's
accommodation.
[
MM/DD
Travel
Expenses
Breakdown
Origin to Destination
/
to
/
to
/
to
/
to
/
to
/
to
Train/Airfare
km
Bus/Other
Fare
Subtotal
yen
Total Travel Expenses
yen
yen
Daily
Allowance
Accommodation
Expenses
yen
 Daily allowance not
necessary
 Reduce daily
allowance
(
)
 Accommodation
expenses not
necessary
 Reduce
accommodation
expenses
yen
(
)
Budget Type to be
Implemented
Accounting
Item/Recipient
Disbursement
Breakdown
Total
Remarks
Total
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
yen
<Budget Unit>
Slip number of the original form to be used when creating more than
one disbursement request
(Entry of this number is not required when creating only one
disbursement request)
2
0
1
3
Checked by
Receipt by a
person in
charge
0
* Personal information on this form will not be used for any purpose other than the payment of travel and transportation expenses. The University will
destroy this form after the safekeeping period.