Box 22, Folder 19, Document 1

http://allenarchive.iac.gatech.edu/originals/ahc_CAR_015_022_019_001.pdf

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Box 22, Folder 19, Document 1

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Copy f or Mayor Allen
STANDARD FORM NO. 1012a
7 G AO 5300
10 12-206
VOUCHER
PA YEE"S NAME
,...,...,..,..,..,•.,
0.
PAID BY
Ivan Allen Jr .
MAILING ADDRESS
RESIDENCE
O FFICIAL DUTY STATION
w
Atl.anta,. Georgi a
on . D. C.
TRAVEL ADVANCE
FOR TRAVEL AND OTHER EXPENSES
TO (DA"rE )
er 2
ovember 28 1
APPLICABLE TRAVEL AUTHORIZATION(S )
NO.
s NONE
O utstanding
Amount co be applied
DATE
11..10..66
Balance to remain
S
outstanding
TRANSPORTATION REQUESTS ISSUED
TRANSPORTATION
REQUEST NUMBER
AGENrs
VALUATION
OF TICKET
INIT IA LS O F
CARRI ER
ISSUING
TICKET
MO D E. CLASS
O F SERVICE.
ANO ACCOMMODATIONS '
POINTS OF T RAVEL
DATE
ISSUED
FROM-
TO -
AMOUNT
CLAIMED
~
APPROVED ( Supervisory an_d other approvals when required)
Dollars
C ts
116
00
DIFFERENCES:

---- ------------------- -- ---------- --------+-------+------------ ------ ----- -- --- ---- ------------- ------ -+-------+-NEXT PREVIO US VO UCHER PAID UNDER SAME TRAVEL AUTHORITY
VOUCHER NO.
D .O. SYM BOL
DATE (MONTH - YEAR)
Total verified correct for charge co appropriacion (s)
Applied to trave l advance (appropriation symbol )
N ETTO
TRAVELER
ACCOUNTING CLASSIFICATION ( Appropriation symbol must be shown; other classification optional)
• Abbreviations for Pullman accom modations: MR, master room; D R, drawinl( room ; CP, compartment; BR, bedroom ; DSR, duplex single room ; RM, roomette;
ORM, duplex roomette ; SOS, sing le occupancy section ; LB, lower berth; UB, upper berrh ; LB-UB, lower and upper berth ; S1 seat.
�SCHEDULE OF EXPENSES AND AMOUNTS CLAIMED
PREVIOUS TEMPORAR¥ DUTY (Comp lete these blocks only if in tra vel status immediately prior to period co vered by this voucher and if administratively required )
DEPARTURE FROM OFFICIAL STATION
TEMPORARY DUTY STATION LAST DAY OF PRECEDING VOUCHER PERIOD
(DATE)
( LOCATION )
! (HOUR )
-
-
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DATE
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OTHER
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SUBSISTENCE
-
au-port
a.u--pon to noi:.eJ.
uiem
i:-~
MILEAGE
ueorgi.a. b :·uu pm Via Delta
A't..l.an'ta;
w.,_, ~ n.:.,_r.on.
,v.·.1: ;r.v,i:;:u
IL':SXl.
No. OF
MILES
AMOUNT CLAIMED
Eastern Standard Time
~
IJ.;t:t.T..L
-
AUTHORIZED
MILEAGE
RATE _ _ q
SPEEDOMETER
READI NGS
-
ember
-
,.
NATIJRE OF EXPENSE
19- u -
( DATE OF ARRJVAL)
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Grand total to face of voucher
(Subtota ls , to be carried forward if necessary)
11
..
JnAnn
U. S. GOVERNMENT PRINTIN 2(t: 1c()Q.96l
0-,61
C

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