General Information (please complete all fields)

Please complete all necessary fields. When done, your responses will be sent directly to our office electronically. If you have any questions about this report, please contact the State Travel Management Program at stmp@cpa.state.tx.us or (512) 463-3435.

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FY11 Hotel Rate Agreement (HRA) number:

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Hotel name:

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Hotel address:

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Person preparing report:

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Phone number:

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