MM
DD
YYYY
Request for the Payment of RA's Commuting Transportation Allowance
Researcher in charge (Affiliation/Job Title)
(Name)
Seal
[Budget type to be implemented]
I hereby report that the following person is now engaged in assisting research work and request the payment of
transportation allowance for commuting.
Details
 Research assistant (claimant for commuting transportation allowance)
Furigana
Name
Seal
Address
(〒
-
)
 Place of work
 Month work
performed
 Number of days to be
covered
day(s)
 Commuting route (Be sure to fill in the area encircled by the bold line.)
Date
Section for use of public
transportation
/
to
/
to
/
to
/
to
Name of
public
transportation
Train fair
yen
Bus
Other
yen
One way/
Round
trip
Subtotal
×
Number
of work
days
day(s)
Total
yen
×
×
×
×
Amount Paid
yen
*
*
*
*
Please submit this request along with the "Part-Time Employee Attendance Book".
The submission of a "Report on Business Trip" is not required.
The "Date" column on the left is not required if the same route is used every time.
Please fill in the "Date" column only to receive payments for specific dates.
*
Personal information will not be used for any purpose other than the payment of the transportation allowance for commuting.
The university will destroy this form after the safekeeping period.
Research Division Form 3-3, April 2015 Version