Box 22, Folder 2, Document 31

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Box 22, Folder 2, Document 31

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STANDARD FORM 1012-A
7 GAO 5300
1012-208

TRAVEL VOUCHER iene ai

MEMORANDUM

VOUCHER NO.

DEPARTMENT, BUREAU, OR ESTABLISHMENT

















PAYEE’S NAME SCHEDULE NO.
MAILING ADDRESS PAID BY
City Hall
Atlanta, Georgia
OFFICIAL DUTY STATION RESIDENCE
__Atlenta, Ga, Atlanta, Ga
FOR TRAVEL AND OTHER EXPENSES TRAVEL ADVANCE CHECK NO.



FROM (DATE) | TO (DATE) Outstanding $

10/27 10/28/66

APPLICABLE TRAVEL AUTHORIZATION (S) - Amount to be applied



































NO. | DATE
Balance to remain
outstanding t
TRANSPORTATION REQUESTS ISSUED
.¢_| INITIALS OF | MODE, CLASS
TRANSPORTATION |yAGENTS |) “CARRIER | OF SERVICE, | DATE RO ee ee
REQUEST NUMBER |r YATION| IssuING | AND ACCOM. | ISSUED
TICKET | MODATIONS* FROM— * TO—
AMOUNT Dollars Cts
CLAIMED
—> 111.10
DIFFERENCES:

APPROVED (Supervisory and other approvals when required)







Administrative Officer

NEXT PREVIOUS VOUCHER A UNDER SAME TRAVEL AUTHORITY
VOUCHER NO. D.O. SYMBOL DATE (MONTH=YEAR)



Total verified correct for charge to appropriation(s)





“= Applied to travel advance (appropriation symbol)

NET TO 3
TRAVELER









ACCOUNTING CLASSIFICATION



* Abbreviations for Pullman accommodations: MR, master room; DR, drawing room; CP, compartment; BR, bedroom; DSR, duplex single room; RM, roomette;
DRM, duplex roometie; SOS, single occupancy section: LB, lower berth; UB, upper berth; LB-UB, lower and upper berth; S, seat, ‘
c48—16—78036-2
SCHEDULE OF EXPENSES AND AMOUNTS CLAIMED



PREVIOUS TEMPORARY DUTY (Complete these blocks only if in travel status immediately prior to period covered by this voucher and if admin-
istratively required) ; ; F

DEPARTURE FROM OFFICIAL STATION TEMPORARY DUTY STATION LAST DAY OF PRECEDING VOUCHER PERIO

(DATE) (HOUR) (LOCATION) (DATE OF ARRIVAL)

AUTHORIZED
MILEAGE AMOUNT CLAIMED
NATURE OF EXPENSE

SPEEDOMETER . OF
Rravincs Sad ae MILEAGE SUBSISTENCE OTHER



Grand total to face of voucher
(Subtotals, to be carried forward if necessary) | 21.10

rAS—1§—TRAAART We caves quent rating OFFICK

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