Common Contracts
1 similar Request for Moving Expense Reimbursement contracts
ContractRequest for Moving Expense Reimbursement • September 5th, 2019
AC1099-S (Revised 12/18) State ofNew York REQUEST/AGREEMENT FOR MOVING EXPENSE REIMBURSEMENT Pursuant to Section 202 and 204 of the State Finance Law, reimbursement is requested for moving and travel expenses of the following: (Please check applicable box.) Employee Appointee Last Name First Name MI Suffix Employee ID Address of New Residence City State Zip Address of Old Residence City State Zip Previous Agency Address of Previous Work Location City State Zip New Agency Address of New Work Location City State Zip Title Negotiating Unit Date of Appointment Date probation ended (if applicable) Grade Distances in miles (shortest measurement along public highways): a. From old place of work to new place of work b. From old residence to new place of work Note: If the distance in (a) or (b) is less than 35 miles, the employee is not entitled to reimbursement. c. From old residence to new place of work d. From old residence to old place of work e. The difference (“c” minu
