ࡱ> WYRoot EntryRoot Entry` )HL!XContentsZ*OccDataSummaryInformation(5  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUV[\]^_`abcdefghijklmnopqrstuvwxyz{|}~FBMacrosL!L!GeneralMacroStream(_f\7>ZW1Oh+'0     ܡTravel Voucher or Subvoucher whs/diorTravel Voucher or Subvoucher Changed to make Item 23 fillable 5-10-95 Corrected for .dbf format. 5-18-95 Removed lookup database from item 11. OSD WHS DIOR671@Xp@fjRX6@vf6@@K!GП48Dv` Ol  "2 -%0  00 - -%0  @0@0 -.- "Univers@ LSwUSw0-"Univers@T "LSwUSw0-- 12 5qTRAVEL VOUCHER OR SUBVOUCHER     - -%  pp -.- "Univers@ LSwUSw0-- f2 8?Read Privacy Act Statement, Penalty Statement, and Instructions -- l2 ECon back before completing form. Use typewriter, ink, or ball point  -- f2 R?pen. PRESS HARD. DO NOT use pencil. If more space is needed,-- %2 `continue in remarks.  -%-.- "Univers@5 LSwUSw0-"Univers@ LSwUSw0-- 2 28. AMOUNT PAID-- --.- -- 62 19. GOVERNMENT/DEDUCTIBLE MEALS -000-.- -- (2 510. FOR D.O. USE ONLY.- "Univers@ LSwUSw0-- 02 5(6) Reimbursable ExpensesR - 0.- -- 2 5 (7) Total - 0.- -- "2 5(8) Less Advance - 0.- -- !2 5(9) Amount Owede - 0.- -- 2 5(10) Amount Due -00--.- -- O2 90Exception to SF 1012 approved by GSA/IRMS 12-91.--.- -- 42 ZMElectronic Fund Transfer (EFT) -@0@@0S0-.- --- 2 K3 1. PAYMENT  -p0pqpp}pp0}0-.- -- 2 y5 15. ITINERARY - 0X - 0X - 0X -  0 X - @0@X -XQX0Q0- - 0X - 0X - 0X - 000X - P0PX -XaX0a0-- - (- - 0 - 0- - (- - 0 - 0- - (- - 0 - 0- - (- - 0 -   0- - (0- - 000 - @@0- - (P- - PP0 -%00``-- - +- -  - - - +- -  - - - +- -  - - - +- -  -   - - +0- - 00 - @@- - +P- - PP -%``- -0p0PpP0pQp-.- "Univers@$ LSwUSw0- -- +2 :uc. SUPERVISOR SIGNATURE- -  -pp1p00p-.- -- .2 {17. DURATION OF TDY TRAVEL -  -  -  -    - @@ -aa- - 0 - 0 - 0 -   0 - @@0 -0a0a- -%pP0P0ppppP-.- --- 2 Xs14. HAVE HOUSEH-- *2 XOLD GOODS BEEN SHIPPED?E"Univers@< )LSwUSw0- - - 2 _s - - 2 _(X one) -.- -- 2 K5(1) Per Diem - P0P.- -- 42 [5(2) Actual Expense Allowance - `0`.- -- 2 k5 (3) Mileage - p0p.- -- (2 {5(4) Dependent Travel - 0.- -- 2 5 (5) DLA -@@00- -p0ppp00-.- -- "2 {55. TYPE OF PAYMENT- - "2 { (X as applicable)- -%-.- .-   CG Times* LSwUSw0- - $- ---  -- -.- -- 2 Member/Employee- - -p- - p - p- - -p- - p - p- - -p- - p - p- - -p- - p - p- - - p- -  p  - 0p0- - -@p- - @p@ - PpP- - -`p- - `p` -%ppppp- -%0|X|X00|-.- -- 2 4a. DATE - -|X|q|ppXq-.- "Arialw@ LSwUSw0--- 2 yb. PLACE- -  2  - - N2 /(Home, Office, Base, Activity, City and State; .- - *2 City and Country, etc.)-  -pqpppq- -%ppp- -%pppppp-.- --  2 vc.-- 2 ~wMEANS/-- 2 tMODE OF-- 2 wTRAVEL -%ppp-.- --  2 vd.-- 2 ~REASON--  2 FOR--  2 STOP -%ppp-.- --  2 ye.-- 2 LODGING--  2 COST -%p0p0p-.- --  2 yf.--  2 POC-- 2 MILES -%H H H-.- -- 2 M ACCOMPANIED -%    00 -.- -- 2 +b. RELATIONSHIP -%  p p0 0  -.- -- 2 '%c. DATE OF BIRTH-- 2 .+ OR MARRIAGE -%pp  -.- -- 2  UNACCOMPANIED -%000-.- --  2 5 .-- 32 87. DAYTIME TELEPHONE NUMBER &-- "2 5 AREA CODE - -%pp-.- -- (2 8. TRAVEL ORDER NUMBER- -0qpp00-.- -- !2 512. DEPENDENT(S) - - 42 (X and complete as applicable)- -%0pp00-.- -- 12 511. ORGANIZATION AND STATION- -%p``pppp`-.- .-   - - $zalalz-azlalz ---  --  -%``pp`-.- .-   - - $alal-alal ---  --  -%p00pp-.- -- 92 u!9. PREVIOUS GOVERNMENT PAYMENTS/-- 2 u ADVANCES- -%p00PpPp-.- --- ?2 u%13. DEPENDENTS' ADDRESS ON RECEIPT OF-- 2 u ORDERS - - $2 (Include Zip Code) .-- -0000-.- --  2 5 .-- 2 8 6. ADDRESS.S- -  2 j .-- %2 ma. NUMBER AND STREET-- -%-.- -- 2 b. CI--  2 T.--  2 Y.- -%0pPpP00p-.- --  2 z5 .-- 2 z82. NAME - - L2 z\.(Last, First, Middle Initial) (Print or type) -- -%PppPPp-.- -- 2 zU3. GRADE- -%-.- -- 2 c. STATE- -%00-.- -- 2  d. ZIP CODES- -%p0p0p-.- -- 2 z4. SSN- -%0PHPH`0`0P-.- .-   - - $:PE[P[:E-P:[EPE[: ---  --  -%0HH00-.- .-   - - $:E:E-:EE: ---  -- -.- --  2 MTDY -%0HH00-.- .-   - - $:E:E-:EE: ---  --  -%0pp00-.- -- 2 @a. DATE -000-.- -- -2 518. REIMBURSABLE EXPENSESL -%p((pp-.- -- %2 b. NATURE OF EXPENSE -%(pp((-.- -- 2 5 c. AMOUNT -%ppp-.- -- 2 x d. ALLOWED -%0PP`0`0P-.- - -- "2 [5 d. COMPUTATIONS-  -%000-.- -- -2 5 a. D.O. VOUCHER NUMBERL- -QP0P0Q0-.- -- 2 5 c. PAID BY- -%00PP0-.- - -- 2 :d. DATE- -  - 000 -%-.- -- 2 a. DATE -%XX-.- -- 2  b. NO. OF MEALS -%00(0(P0P00-.- - -- +2 :520.a. CLAIMANT SIGNATURE- -  -%(0p0pP(P(0-.- --- 2 :-b. DATEE- -  -%0pp00p-.- --- 2 {516. POC TRAVEL S- - 2 {y(X one)E-  -%ppp-.- .-   - - $q|q|-q|q| ---  -- -.- -- 2 { OWN/OPERATE -%(p@p@((p-.- .-   - - $2q={q{2=-q2{=q={2 ---  -- -.- -- 2 {E PASSENGERD -%000-.- -- 2 524. COMPUTED BYS- -%000-.- -- $2 523. COLLECTION DATAE- -%-.- -- 2 25. AUDITED BY- -%-.- --- 2 26. TRAVEL ORDER-- 2  POSTED BYR-- -%-.- --- 2  27. RECEIVED--  2  .- - C2 ((Payee Signature and Date or Check No.) -- -%0pp00p-.- -- 32 z522. ACCOUNTING CLASSIFICATION- -%0  0000 -.- - -- 2 +>a. NAME - - 32 +b(Last, First, Middle Initial)-  -%-.- .-   - - $- ---  --  - p - p - p - p - p - p - p -  p  -%p0p0p- - (p - (p - (p - (p - (p - (p - (p -  ( p -%(pp0(0(- - p( - p( - p( - p( - p( - p( - p( -  p ( -%p((0p0p- - 0p - 0p - 0p - 0p - 0p - 0p - 0p -  0 p -%0pp0000- - p0p - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -  0  -`1000`010- -%000-.- -- *2 5 b. SUBVOUCHER NUMBER- -%PP``P-.- .-   - - $Q[Q[-Q[Q[ ---  --  -%0HH00-.- .-   - - $:E:E-:EE: ---  --  -%-.- .-   - - $- ---  -- -.- -- 2 M Dependent(s).- --  2 \ARR - Xp.- --  2 \DEP - Xp.- --  2 \ARR - Xp.- --  2 \DEP - Xp.- --  2 \ARR - Xp.- --  2 \DEP - Xp.- --  2 \ARR - Xp.- --  2 \DEP -  X p.- --  2 +\ARR - 0X0p.- --  2 ;\DEP - @X@p.- --  2 K\ARR - PXPp.- --  2 [\DEP - `X`p.- --  2 k\ARR -%XpppXpX- -%XppXX-.- --  2 \DEP"Arialw@ LSwUSw0- - pp - pp - pp -  p p - @p@p -pap`p`q- -%p`p`ppppp`- - p - p - p - 0p0 - PpP -%ppppp- -%``pp`- -  -  -  -    - @@ -%``- -%``pp`- -%`0`0pp`- -%000@0@00-.- -- *2 ;7e. SUMMARY OF PAYMENT -%0HH 0 0-.- .-   - - $:E:E-:EE: ---  --  -%  -.- .-   - - $- ---  -- -.- - --  2 kYES- -.- - --  2 kNO- -  2 k (E- - "2 kxplain in Remarks)- -.- --  2 DLA-.- --  2 MPCS -  -    -%00- - X -   X -%XX00-- - *- -%- -6W--.- -- +2 0DD FORM 1351-2, JUL 2002      -%0XX00- -%0`X`Xp0p0`- - @0@ - P0P - `0` -%000p0p00- - @@  - PP  - ``  -%0 0 pp0- - @ @p - P Pp - ` `p -% 0p0pp p 0--.- "Univers@ LSwUSw0-- 32 ePREVIOUS EDITION IS OBSOLETE.- - ?- -%-- - ' - -%00- -  - `` - pp -  -  -PP- -%- -%- -%- -%- - 0pPp -%XXX-.- -- 2 sa. DATE -%-.- -- 2 b. NO. OF MEALS - X -  X  -%X0X0X- -  -    -%00- - 00 - 0-.- --  2 i O--  2 i$ --  2 i  - mmS-.- -- 2 jMPayment by Check -%0`H`Hp0p0`-.- .-   - - $:`Ek`k:E-`:kE`Ek: ---  --  -%-.- .-   - - $- ---  -- -.- -- 2 12 HOURS OR LESS -%-.- .-   - - $- ---  -- -.- -- "2 MORE THAN 12 HOURS-- %2 BUT 24 HOURS OR LESS -%-.- .-   - - $- ---  -- -.- -- "2 MORE THAN 24 HOURS -%@@PP@- -P0Pp0pP0q0-.- - -- 92 Z5!21.a. APPROVING OFFICER SIGNATURE- -  -%PPppP-.- - -- 2 Zb. DATEE- -  - 0 - PP - `p - `p - 0X-.- -- 2 Other-.- -- C2 T(Split Disbursement: Amount to Government-- "2 ]Travel Charge Card - p00 - p0p0 -%00000-.- -- +2 5 e. E-MAIL ADDRESS WOWWOWWOWWOWWOWWOWWOWWOWWOWWOW FormFlowFormFlow 2.054 =4 =/V/V DepDate B 'ArrDatete B 2"DepDateA B PlaceA_1 @. 2 Placee @. 2#PlaceI @. 2*MeansA @. H*$/V(/V&/V!*$/V(/V&/VAuto-CommercialCA) PVAuto-GovernmentGA) PVAuto-Private (POV)PAVAuto-GTR/TKTTAV)PAVBus-CommercialCBPAVBus-GovernmentGBPAVBus-Private (POV)PBVBus-GTR/TKTTBV)PBVMotorcycle-CommercialCMMotorcycle-GovernmentGMMotorcycle-Private (POV)Motorcycle-GTR/TKTTMV)Plane-CommercialCPMV)Plane-GovernmentGPMV)Plane-Private (POV)PA)Plane-GTR/TKTTPV)PA)Rail-CommercialCRPA)Rail-GovernmentGRPA)Rail-Private (POV)PR)Rail-GTR/TKTTRV)PR)Vessel-CommercialCV)Vessel-GovernmentGV)Vessel-Private (POV)PVVessel-GTR/TKTTVV)PVCA) PV PMTHRU+1GA) PV PMTHRU+1PAV PMTHRU+1TAV)PAV PMTHRU+1CBPAV PMTHRU+1GBPAV PMTHRU+1PBV PMTHRU+1TBV)PBV PMTHRU+CMPMTHRU+1GMPMTHRU+1PMTHRU+1TMV)PMTHRU+1CPMV)PMTHRU+1GPMV)PMTHRU+1PA)PMTHRU+1TPV)PA)PMTHRU+1CRPA)PMTHRU+1GRPA)PMTHRU+1PR)PMTHRU+1TRV)PR)PMTHRU+1CV)PMTHRU+1GV)PMTHRU+1PVPMTHRU+1TVV)PVPMTHRU+1 |(/V(/VEnter the apppropriate symbols (two letters): GTR/TKT - T Auto - A GovTrans - G Motorcycle -M ComTrans - C Bus - B PrivTrans(POV) - P Plane - P Rail - R Vessel - VMeansomb @. HR+/V-/V(R+/V-/VAuto-CommercialCA) PVAuto-GovernmentGA) PVAuto-Private (POV)PAVAuto-GTR/TKTTAV)PAVBus-CommercialCBPAVBus-GovernmentGBPAVBus-Private (POV)PBVBus-GTR/TKTTBV)PBVMotorcycle-CommercialCMMotorcycle-GovernmentGMMotorcycle-Private (POV)Motorcycle-GTR/TKTTMV)Plane-CommercialCPMV)Plane-GovernmentGPMV)Plane-Private (POV)PP)Plane-GTR/TKTTPV)PP)Rail-CommercialCRPP)Rail-GovernmentGRPP)Rail-Private (POV)PR)Rail-GTR/TKTTRV)PR)Vessel-CommercialCV)Vessel-GovernmentGV)Vessel-Private (POV)PVVessel-GTR/TKTTVV)PVCA) PV PMTHRU+1GA) PV PMTHRU+1PAV PMTHRU+1TAV)PAV PMTHRU+1CBPAV PMTHRU+1GBPAV PMTHRU+1PBV PMTHRU+1TBV)PBV PMTHRU+CMPMTHRU+1GMPMTHRU+1PMTHRU+1TMV)PMTHRU+1CPMV)PMTHRU+1GPMV)PMTHRU+1PP)PMTHRU+1TPV)PP)PMTHRU+1CRPP)PMTHRU+1GRPP)PMTHRU+1PR)PMTHRU+1TRV)PR)PMTHRU+1CV)PMTHRU+1GV)PMTHRU+1PVPMTHRU+1TVV)PVPMTHRU+1Reasonmb @. H0/Vf1/V$0/Vf1/VAuthorized DelayADion Awaiting TransportationLeave En RouteLVationMission CompleteMCionTemporary DutyTDCionADion ATTHRU+1ATTHRU+1LVationATTHRU+1MCionATTHRU+1TDCionATTHRU+1ReasonH @. H2/VF3/V+2/VF3/VAuthorized DelayADion Awaiting TransportationLeave En RouteLVationMission CompleteMCionTemporary DutyTDCionADion ATTHRU+1ATTHRU+1LVationATTHRU+1MCionATTHRU+1TDCionATTHRU+1GovMeal @. 2%GovMealsH @. 2,POCMile@. &POCMileH@. -OwnOperate@ &8/V!.&8/V <8/V<8/V Passenger@ 9/V$/9/V 9/V9/V xEFTsh@ :/V!:/V :/V:/V xsplitect@ ;/V ;/V ;/V;/V TypeTDY@ /V >/V >/V>/V TypeMember@ ?/V?/V ?/V?/V TypeDep@ @/V @/V @/V@/V TypeDLA@ A/V A/V A/VA/V Namelt @. 2SNGradet @. 2SNSSNult @. SNStreetAddr @. 2SN CityAddr @. 2SNStateAddr @. SNZipAddr @. SNPhoneOff @. I/VSNI/VI/VI/V() -TONumber @. 2PrevAdv @. dOrgStation @. dSNAccomp@ JM/V!JM/V `M/V`M/V UnAccomp@ HN/V$HN/V ^N/V^N/V DepAddr @. dShipped@ &P/V!&P/V 

SupvDate @. ?CollData @. dMCompBy @. 2NAuditBy @. 2OTOPostBy @. 2PReceived @. 2QAmtPaidCB. 2RpaycctB. summpayCB. Gtotalpay. fi/VggQHfi/VggQ[SUMMPAY]ggQggQhgQhgQSUMMPAY&ggQggQ@0lessadvCB. Iamtowed. 2k/VvhgQJ2k/VvhgQ[TOTALPAY]-[LESSADV]hgQhgQhgQhgQTOTALPAY-8LESSADVL(hgQ(hgQ@@ 0amtdueCB. Kmealdtbm@. !9nomealsbD@. :xcheck@ o/V$o/V |o/V|o/V o/Vo/V  o/Vo/V[xEFT]=0xless12r@ p/V!0p/V p/Vp/V xmore12r@ q/V"1q/V q/Vq/V xmore24r@ r/V$2r/V r/Vr/V vouchno @. Bsubvouch @. Cpaidby @. Dcompst @. E perdiemCB. FApprSign @. 2@ApprDate @. Aemailt @. dBASESwiss"Univers (WN)"Arial"CG Times (WN)Courier1Univers ATT"Univers (W1)"CG Times (W1)CG TimesUnivers"RomanYa εų\KhC+J`?).RRN,R(SD@RAK,(Rh RQ g+SI.I.g+g+: +.Rȴ HWnR*yRWjW/VRDD1351-2.FRZ2"-+WWW;TH1jJ8c|Ԕp()\KhC\KhC1!#`0'11!$B#`/w0a  |/V*gQ|/VgQ TRAVEL VOUCHER OR SUBVOUCHER !s/`00a  v}/VgQv}/VgQRead Privacy Act Statement, Penalty Statement, and Instructions on back before completing form. Use typewriter, ink, or ball point pen. PRESS HARD. DO NOT use pencil. If more space is needed, continue in remarks.0'1a  AmtPaid $/VhNgQ$/VhNgQ  28. AMOUNT PAID U ;a0l1a  /V#DgQ/VDgQ19. GOVERNMENT/DEDUCTIBLE MEALSBw00a  v/V"gQv/V"gQ10. FOR D.O. USE ONLYB.&a1 3XE2Zi  SummPay_2  /V/V(/VWK(/VWKJ/VAgQJ/VAgQ\/VAgQ\/VAgQt/VDBgQt/VDBgQ/VDgQ/VDgQ(6) Reimbursable Expenses(7) Total(8) Less Advance(9) Amount Owed(10) Amount DueBO%*'28X (/V5lOgQ(/VlOgQException to SF 1012 approved by GSA/IRMS 12-91. mJR6c5X /V"gQ/VgQElectronic Fund Transfer (EFT)1$BBU#w{0/VgQ/VgQ 1. PAYMENT 1f|f|#U ]0  ,/VRgQ,/VRgQ15. ITINERARY1Z d#x@0 )!X ;%[Q<H@  ArrDatete f/Vf/V1Zt#@1 )!X ;%:~[QHK  DepDate /V/VBt{x1%X    /V/V]t-xM1%X    /V/Vf|~K.l 1  SupvSign z/V'4FgQz/V4FgQ  c. SUPERVISOR SIGNATURE B;1a  */VڍWK*/VڍWK17. DURATION OF TDY TRAVEL]t-xM1 )!X qn<@%  Reasonmb p/Vp/VBt{x1 )!X =<@  POCMile /V/V*Y!(R+%.LQWR(+Ķ Wx/V((RH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]*Y!(R+%.LQWR(+Ķ f|I[Bq| >U0a(/VSgQ(/VgQ 14. HAVE HOUSEH OLD GOODS BEEN SHIPPED?   (X one)BgS.#&1 3XExw2  SummPay_1  /V/V/VgQ(/V>gQL/V>gQL/V>gQ`/VH?gQ`/VH?gQ|/VXWK|/VXWK(1) Per Diem(2) Actual Expense Allowance(3) Mileage(4) Dependent Travel(5) DLABsH00a   /V2gQ/VgQ5. TYPE OF PAYMENT  (X as applicable)՝Pٔ0X TypeMember  TA0X /VgQ/VgQMember/Employeef| l-1%X  ژ/Vژ/V1Z~#]@l0X /VgQ/VgQa. DATE ___Zf|x@] l0X ./VigQ./VgQ b. PLACE  (Home, Office, Base, Activity, City and State; City and Country, etc.)sf|Rl x0X   PlaceA_1  f| l-x0X  MeansA  f|}| U-l0X r/V/Vr/V/Vc. MEANS/ MODE OF TRAVEL}|]-UMl0X /V/V/V/Vd. REASON FOR STOP]}|MU{l0X /V/V/V/Ve. LODGING COSTf|B{Ul0X P/V gQP/V gQf. POC MILESmJ%)50X  /Vr!gQ/Vr!gQACCOMPANIED))7:&0 /V!gQ/V!gQb. RELATIONSHIP))f|7: &0 /V!"gQ/V"gQc. DATE OF BIRTH OR MARRIAGE%f|) 0X  Ƣ/V"#gQƢ/V"#gQUNACCOMPANIED1x#0a PhoneOff /V;t#gQ/Vt#gQ  7. DAYTIME TELEPHONE NUMBER & AREA CODE xf| 0a  TONumber /V$gQ/V$gQ 8. TRAVEL ORDER NUMBER 1f|%# 0a  \/V=%gQ\/V%gQ12. DEPENDENT(S)  (X and complete as applicable)1f|# 0a  OrgStation l/V!Z&gQl/VZ&gQ 11. ORGANIZATION AND STATION f|k5^| IU0X Shipped  k]q|;IMU0X NotShipped  f|xB 0a  PrevAdv /V4d'gQ/Vd'gQ 9. PREVIOUS GOVERNMENT PAYMENTS/ ADVANCES f|BI[ >0a  DepAddr /VZ(gQ/V(gQ  13. DEPENDENTS' ADDRESS ON RECEIPT OF ORDERS  (Include Zip Code)  1ڔ#0  StreetAddr /V:*gQ/V*gQ  6. ADDRESS.  a. NUMBER AND STREET ڔ/0X  CityAddr /VL+gQ/VL+gQ b. CI T Y 1sR[ڔ#0a  Name ح/VK@,gQح/V@,gQ  2. NAME  (Last, First, Middle Initial) (Print or type)  R[sڔ/0a  Grade /V-gQ/V-gQ 3. GRADE ڔ/X0X  StateAddr د/V.gQد/V.gQ c. STATE ڔBX0X ZipAddr /Vn/gQ/Vn/gQ d. ZIP CODE sBڔ/0a  SSN /VV0gQ/VV0gQ 4. SSN *Y!(R+%.LQWR(+Ķ W/VRH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]*Y!(R+%.LQWR(+Ķ 1RmJ6c#50X xEFTsh  BT[ڔ0X TypeTDY  [TuڔX Գ/V>1gQԳ/V>1gQTDYBi[0X TypeDep  1s#&R21 HgQ/V>HgQ  20.a. CLAIMANT SIGNATURE 1~Kf|l 1  ClaimDate /VTIgQ/VTIgQ  b. DATE 1#;1a/V)@gQ/V@gQ 16. POC TRAVEL  (X one)H/r1X OwnOperate   o!X /V@gQ/V@gQOWN/OPERATE1J1X Passenger   JI5X P/V@gQP/V@gQPASSENGER1#o'1a  CompBy 2/VPgQ2/VPgQ 24. COMPUTED BY 1#01a  CollData /VpMgQ/VpMgQ 23. COLLECTION DATA o'1a  AuditBy /VQgQ/VQgQ 25. AUDITED BY '1a TOPostBy/V/|RgQ/V|RgQ  26. TRAVEL ORDER POSTED BY '1a  Received </VNSgQ</VSgQ  27. RECEIVED  (Payee Signature and Date or Check No.)  1#01a  AcctClass WK"HJgQWKHJgQ 22. ACCOUNTING CLASSIFICATION 1)7:#&0 JWK83gQJWK3gQ a. NAME  (Last, First, Middle Initial)՝ݔf0X TypeOther  f|rK 2;1)X    ReimbAllw  WKWK1f|rK2 1)X    ReimbAmt  WKWK*Y!(R+%.LQWR(+Ķ WWKRH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]*Y!(R+%.LQWR(+Ķ s1rKR21)X  q r( }/ ReimbNtr  WKWK1srK#2R1)X  - q +yl ReimbDat  WKWKBkBI00)X    compsatns  WKWKB00X subvouch WK4gQWK4gQ b. SUBVOUCHER NUMBER R=c0X xsplitect  Bߔ[k0X TypePCS  ՝i0X TypeDLA  [iX  WK5gQWK5gQDependent(s)Zs@xR1% Zhsc%y4   WKWK"WK5gQ"WK5gQ4WK.6gQ4WK.6gQFWK~6gQFWK~6gQXWKH;gQXWKH;gQjWK;gQjWK;gQ|WK;gQ|WK;gQWK8gQ WK>gQe. SUMMARY OF PAYMENT1%mJ)#50X Accomp  %)0X UnAccomp  5kI[|I5UXdWK7gQdWK7gQ YES]kB^|MIUXWK/p7gQWKp7gQ NO  (E xplain in Remarks)dX  WK7gQWK7gQDLAndent(s)[ڔ|tcX  WKN8gQWKN8gQPCSyK;x{1)X   mealdtam   /V /V7lyK{x1)X   nomealsa  /V/V]-lMx0M7Xě'c?k0X ItinYear   1>:"#)3X /VUgQ/VUgQDD FORM 1351-2, JUL 20021xZ#l@x0X  DepDateA  1tZ#@1X  ArrDateH  17:[|#&U0)X -,&=0@  Depd /V/V7:)[|&U0)X  Relat /V/V*Y!(R+%.LQWR(+Ķ W/VXXRH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]*Y!(R+%.LQWR(+Ķ )7:f|[|& U0)X ))f|+:i* DateRel /V/V)hS@"'3 /V!nUgQ/VnUgQPREVIOUS EDITION IS OBSOLETE.]Ml{x0B{lx0;;aa.d021 )X  summpay /V/V.&20>1X totalpay  .&>0I1X lessadv  .8I0U1X amtowed  .8U0a1X amtdue  f|~Kf|l  a7lU .lx1  /VEgQ /VEgQa. DATETR/M.U l0x1 /VEgQ/VEgQb. NO. OF MEALS7l.yKx1)X   mealdtbm  /V/V.yKx01)X   nomealsb  ^/V^/VBBaaN K;l;a6c]s paycc /V8gQ/V8gQ  $   p4^pmJ6cs5oX /V8gQ/V8gQPayment by Check16cmJs#50X xcheck  ];M21X xless12r   ]BͶM2X /V@AgQ/V@AgQ12 HOURS OR LESS];2MI1X xmore12r   ]ͶBM2JX  /V+BgQ /VBgQMORE THAN 12 HOURS BUT 24 HOURS OR LESS];IMa1X xmore24r   ]BMJaX /VCgQ/VCgQMORE THAN 24 HOURS.Sd00X perdiem  1l.#1a  ApprSign \/V0TKgQ\/VTKgQ  21.a. APPROVING OFFICER SIGNATURE .l01X  ApprDate ^/V|LgQ^/V|LgQ  b. DATE B.&&X.ll0a]t]MM*Y!(R+%.LQWR(+Ķ W/V;;RH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]*Y!(R+%.LQWR(+Ķ t{{1Z#@XڔB` X 2/VJ9gQ2/VJ9gQOtherO٨6c,X /V?9gQ/V9gQSplit Disbursement: Amount to Government Travel Charge CardBsBa1f|Bf|#UUa1Bx#0 email  /V:gQ /V:gQ e. E-MAIL ADDRESS 11=9119*=0a  Remarks @/V8@/V INDICATE DATES ON WHICH LEAVE WAS TAKEN: 11R=:WX  /V/VPRIVACY ACT STATEMENT1Jk=6S1a   /V/VINSTRUCTIONSk' SX1=1a   x/Vx/VPENALTY STATEMENT9RDWX /V/V AUTHORITY:  5 U.S.C. Section 5701, 37 U.S.C. Sections 404 - 427, 5 U.S.C. Section 301, DoDFMR 7000.14-R, Vol. 9, and E.O. 9397.  PRINCIPAL PURPOSE(S) : This record is used for reviewing, approving, accounting, and disbursing money for claims submitted by Department of Defense (DoD) travelers for official Government travel. The Social Security number (SSN) is used to maintain a numerical identification filing system for filing and retrieving individual claims.  ROUTINE USE(S):  Disclosures are permitted under 5 U.S.C. 552a(b), Privacy Act of 1974, as amended. In addition, information may be disclosed to the Internal Revenue Service for travel allowances, which are subject to Federal income taxes, and for any DoD "Blanket Routine Use" as published in the Federal Register.  DISCLOSURE:  Voluntary; however, failure to furnish the information requested may result in total or partial denial of the amount claimed.9V JD 6X  j/Vj/VThere are severe criminal and civil penalties for knowingly submitting a false, fictitious, or fraudulent claim (U.S. Code, Title 18, Sections 287 and 1001 and Title 31, Section 3729).1#=sX /V#/VDD FORM 1351-2 (BACK), JUL 2002(Bkz' KS gQDgQ ITEM 1 - PAYMENT   Member must be on electronic funds (EFT) to participate in split disbursement. Split disbursement is a payment method by which you may elect to pay your official travel card bill and forward the remaining settlement dollars to your predesignated account. For example, $250.00 in the "Amount to Government Travel Charge Card" block means that $250.00 of your travel settlement will be electronically sent to the charge card company. Any dollars remaining on this settlement will automatically be sent to your predesignated account. Should you elect to send more dollars than you are entitled, "all" of the settlement will be forwarded to the charge card company. Notification: you will receive your regular monthly billing statement from the Government Travel Charge Card contractor; it will state: paid by Government, $250.00, 0 due. If you forwarded less dollars than you owe, the statement will read as: paid by Government, $250.00, $15.00 now due. Payment by check is made to travelers only when EFT payment is not directed.  REQUIRED ATTACHMENTS  1. Original and/or copies of all travel orders and amendments, as applicable. 2. Two copies of dependent travel authorization if issued. 3. Copies of secretarial approval of travel if claim concerns parents who either did not reside in your household before their travel and/or will not reside in your household after travel. 4. Copy of GTR, MTA or ticket used. 5. Hotel/motel receipts and any item of expense claimed in an amount of $75.00 or more. 6. Other attachments will be as directed.IkaS gQlgQ ITEM 15 - ITINERARY - SYMBOLS   15c. MEANS/MODE OF TRAVEL   (Use two letters) dc5 gQgQGTR/TKT Government Transportation Commercial Transportation  (Own expense)  Privately Owned Conveyance  (POC) cd5S gQgQ- T - G - C - P_dx  gQ/ gQAutomobile Motorcycle Bus Plane Rail Vesseld > gQ> gQ- A - M - B - P - R - VI  gQ" gQ 15d. REASON FOR STOP hSRS&# > gQe> gQAuthorized Delay Authorized Return Awaiting Transportation Hospital Admittance Hospital DischargehS|tRS&D# , gQ, gQ- AD - AR - AT - HA - HDIRS' #  gQ gQ ITEM 15e. LODGING COST   Enter the total cost for lodging.  ITEM 19 - DEDUCTIBLE MEALS  Meals consumed by a member/employee when furnished with or without charge incident to an official assignment by sources other than a government mess  (see JFTR, par. U4125-A3g and JTR, par. C4554-B for definition of deductible meals) . Meals furnished on commercial aircraft or by private individuals are not considered deductible meals.*Y!(R+%.LQWR(+Ķ WgQRH^Rv!H/Vv!R.HW^R(_,T(**Zd״S:ε(i4u+ć]$5*Y!(R+%.LQWR(+Ķ 19*=0a  WKWK29. REMARKSKRSZ# 2gQC2gQLeave En Route Mission Complete Temporary Duty Voluntary Return K gQgQ- LV - MC - TD - VR