ML19282D071

Travel Voucher for Jm Stephens for 780626

ML19282D071
Person / Time
Issue date:	06/26/1978
From:	Stephen J NRC COMMISSION (OCM)
To:
References
NUDOCS 7905110192
Download: ML19282D071 (2)

Text

~--- e vt U.S. NUCLEAR REGULATCRY COMMISSION

$^.f,"*Na,',13.

(.S=

TRAVEL VOUCHER (Part 1) 6.h.

• umy.l;p?2.

(.;:.==.LC A ppendir 1501 e instnictions for completing 2:== arm)

-t (Do t Remove Carbons)

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W 1.

,2,. DevissondOffhce

'4. Acorest Coos

5. Name of Traveisr (7,rst two metsals and last name)

I 3.

a Cod.

Vouch-No.

g Amendment paave blank)

OHome D O't c=

. f ~ *,.:

g, b@O 3- *70 ' u"foo Oso-w JhlStephens KEnnio/

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6. a. Ma.ung Acoress (AO. Son. Ssreet or Otisco)

{D. City. State -

c. Zap Code

' EaEM510.EEM Omc "

.N 11M r Nashington. D.C.'

205 %

7. Hes.dence if Ditterent from item 6

8. Official Outy Station (Cry. State)

_ For Travel and Otner Expensee (Ch, State)ington,' D.C Washington D.C.

06 26 78 05 26 73

9. From (MM DO YD

10. To: (MM 00 YY) sn e

NRC TO BE BILLEO:

11. Number Page 13. Enter

14. Identilecation.

1$. Carrier or

16. Points of Travet Covered by

17. Mode and

18. Amount Eaca Page too.

Appropriate TR No Invoace Rental Car TIR or Period of Car Rental Cass of Service to be Billed Consecutavely Type Code No..

(Name or (MM OD YY)

Here etc (see lastrue-Initials l tions)

12. Number item TYPE From To y

Eacn item COCES Consecutively

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.i' Un"'"P 1

^Y, A.

D 3s651,048 Belt 2 -

Wahhingt'on -

Bdsto'n ;-E y

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$d Air +fnes (and-rettrnS s.TR.

c,e.

way C's Rental C-THIS D0 :UMENT CONTWS l

e 8284T P00R; QUAUTY PAGE S Em Other

19. Number of Bthing items if more scace is required for additional belling items use another

20. Total amount Usted on trus Page 1

Form NRC64, and complete items 1 thru 5. and items 11 thru 20.

to be billed on

< ihis pace

-9 70

21. Authorizatiort

23. For Change of Duty Station-todividuals included in trils Clair?t:

No.-

.,,e OEmpioyee i

~

ra. Reed Carefuity pr ucher incio;6,i,g~.~. ----- ; -

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No. of Chiidren Ages 12 to 20-and parents roaoaana, mars tne appropriate O Employee and Spoyse

] Voucher Includes Shared "Cos't (Erplate in Perf 2)

O 5p*u'e No. of Chiidren under ir

] Conaustant Travel Expenses calmed

25. Travet Advance (For Office f CONTROLLER Use)

] Abandonment cf Travel (Explain in part 2.). '

Outstanding balance s 355.00

] Comparative Coat Statement included I-

"f

Amount to be appijed q,.

7.q 3a

,4.

Jy

] Leave Taken in conjunction wtth Trip (Espla/n in Part 2.)

Balance to rermain outstanding.-

I

~5 * *5. ri m

-n.s w so

] Local Trecei 26., Vor Offsoe of CONTROLLER USE) Examiner's Deductions..

.s

] Additional Vouchers will be Submitted

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] Refund Oue on Unused Ticket andtor Refund S!!p (Esplain in Pt. 2)

] Remittance Attached in Amt. of 3

} House Hunting 1.

Exarnined by-2 3 g Date ' O f o / *1]

27. Actual Tltne in Trave 6 for

23. Schedule No. (For Ottice

29. Total Arnount Cairned

30. Total Foreign Costs

31. Net to Traveler (For Ot/ ice Per Diem Casculation of CONTROLLER Use)

Sncluded in t1em 29 of CONTROLLER Usa)

Days Quarters n't ~ " O,

2. es-tvswCo,,ect Payment o, cred,i has noi been.,,eceived-ny

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,- :.--/i. + ssyrdture or,TranM/-v

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2. Ao-ed, tong distancneiepnon. can. ar. cerimod as necessarr-

5. C-ufied Correct and erop-[rawani=-- ;,

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in me ini.rw of.tne covernment..

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r-ic w eM%,W *ml Tvrr> %.8/c/7g.m (Signature of Approving Otticial) **

. (De fe)

,,Ja thomed Certifyong Officer)

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(Care) v

, 35. Accounting cassification (for Ottice or CONTROLLER Use): r,Use);

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's. ': iobject. *, _

Cass O=t ait B & R Cass (

OtWecr b'f

-' C I Amount Cass Datail I 'l & R Oass Amount C: ass Detall B & R Cass Amount

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raucsent Ca m-Fan f canon of an item in an empense account works a forfe.ture of 2he claim GS U.S.C. 2518) and may result in a fine of not more tnan s

riprisonment so, cet enore enan 5 years or both (18 U.S.C. 237; id.1CU11 110.000 or

• tt Long Distance teiephone canis are incJuded, the ap. stowing off.cer must have been authorized in writing by the head of the Department or Agency to is U.S C. Mcal iy eE REVERSE OF PA YEE OPY Fina parvar-v ar-v ers venacus 1905 ; 3 9gyq_

".2-.." 2

- - -ii.. 5..

AND AMOUNTS CLAIMED E"....."

-Do Not Remore carbons /

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PACE t.Jd.

• DIV/ OFFICE 10 VOUCHER NO.

Name OEPART FROM OFFICE Olv.

SU S.UN.IT (DATE)

(HOUR)

MM DD YY

.,M I

'70 00 J H Stephens PM DATE NATURE OF EXPENSE AUTHO RIZED NUMBER OF AMOUNT CLAIMED MILEAG E OF Mit E5 i,78 Rate c

6/26,riesioence to Mrporc (buA)

LV 7:45 a.m.

LV: National Airport DL-214 8:55 a.m.

AR: Boston, Massachusetts 10:03 a.m.

LV: Airport (Accoapanied R. Kennedy 8 R. Stratford in Rental Car - claimed on R. Kennedy's voucher)

AR: Manchester, New Hampshire 12:00 noon Attend Hearings on Seabrook Nuclear Power Plant LV: Manchester (Rental car) 6:30 a.m.

AR: Boston, Massachusetts 8:20 p.m.

LV: Boston, Massachusetts DL-301 8:50 o.m.

AR: National Airport 10:00 p.m.

Airport to Residence (GOA)

AR 11:00 a.m.

PER DIEM 3/4 day e $16/ day 12 00 o.: v...'.'c.

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See Arvef$e Of Payee Copy for Privacy Act Statement PAYEE COPY