Section Plc 1003.06 - Requests for Reimbursable Travel Expenses(a) Any member who wishes to receive reimbursement for mileage, parking, or tolls, or any combination thereof, shall submit the information listed in (e), below, to the director of the division of licensing and board administration using state of New Hampshire Form A-4M "STATE OF NEW HAMPSHIRE PAYMENT VOUCHER IN-STATE REIMBURSEMENT REQUEST", available by going to https://www.das.nh.gov/hr/forms.aspx and selecting the applicable travel reimbursement form.(b) No member shall submit a request more frequently than once in any calendar month.(c) Each request shall be signed by the member submitting the request, which shall constitute the member's attestation that:(1) The member did in fact attend each meeting or conduct the board-related business for which travel expenses are being requested;(2) The member did in fact drive the miles for which mileage reimbursement is being requested or, if a request is submitted prior to leaving a meeting, that the member will drive the miles for which a mileage reimbursement is being requested;(3) The member did in fact pay the amounts being requested for parking and tolls, as shown on the receipts submitted with the request; and(4) The member understands that the submission of false, incomplete, or misleading information may violate RSA 641 relative to falsification in official matters.(d) The submission of false, incomplete, or misleading information shall constitute grounds for the director to deny the request and to seek reimbursement of any amounts paid based on the request.(e) The information required to be submitted shall be as follows: (1) The time period covered by the request;(2) The member's name, address, and employee vendor number;(3) The name of the supported board for which the member attended a meeting or conducted board-related business and, if the meeting was of a sub-unit, the name of the sub-unit;(4) The date of each meeting attended or on which board-related business was conducted for which reimbursement for mileage, parking, or tolls, or any combination thereof, is being requested;(5) For mileage reimbursement, the miles driven to the location of the meeting or board-related business and from the meeting or board-related business, as described in Plc 1003.05(c); and(6) For reimbursement of parking or tolls, the amount paid for each as shown by receipts submitted with the request.(f) A member submitting a request for travel expense reimbursement for board-related business shall submit a copy of the signed authorization received pursuant to Plc 1003.08 with the request.N.H. Admin. Code § Plc 1003.06
#13266, INTERIM, eff 9-22-21Amended by Volume XLII Number 2, Filed January 13, 2022, Proposed by #13316, Effective 12/22/2021, Expires 12/22/2031Amended by Number 24, Filed June 13, 2024, Proposed by #13952, Effective 5/15/2024, Expires 5/15/2034.