ML19312D000

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Travel Voucher for V Gilinsky on 790629-30
ML19312D000
Person / Time
Issue date: 07/19/1979
From: Gilinsky V
NRC COMMISSION (OCM)
To:
Shared Package
ML19312C990 List:
References
NUDOCS 8002080347
Download: ML19312D000 (2)
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Text

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U.S. NUCLEAR REGULATORY COMMISSION (AC Appendix H01 for instructionsfor completing i( em)'

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TR AVEL VOUCHER (Part 1)

Co,npiroaer oeners U.S.

sf May 2.19t2

-- (5s (Do Not Remove Carbons)

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& ~ s.

2. Divisionsoffice 3.

Q4. Address Code

5. Name of Traveder (perst two #mtsa s and last name) s Voucher No.

j Cod. /..

O nome O O".ca

.L E. y G ameadmea' c= o' a=>

e 4

a.

M O

  • 70 o",,"t 00 j. Ospeciai Vl l GILINSKY S
6. c. Masiong Address (P.O. Sor $treet or Otr/ce)
b. City. 6 tate
c. Zip Code OCM, Room 1103, H-Street Washington, D. C.

20555 '*

T. Feesadence'il differentTr~om lt'em 6

8. Ottacist Outy station (Csty. State)

For Trave 6 and Other Expename (City. Stere)

9. From (MM OD m i10.To I/[0/79 u

m Dethesda, Ed.

Washington, D.C.

06/29/79 l

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NRC TO BE BILLED:

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t1. Number PaGe 13. Enter

14. Identihcation
15. Carrier or
16. Points of Travel Covered by IF. Mode and
18. Amount Apprcbartate TR No., invoice Hental Car TIR or Per6od of Car Rental Case of Service to be Billed Each Pace No.

Type No..

(Name or (MM OD YY)

' ...i Consecutively

^*

Here etc (see instrue.

Initials) 1 riaan

12. Number item TYPE From To ir Each item CODES s..

Consecutively Beo6nn6ry A=TP

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with "t*

Round

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'.w' Trip R = TR One l

Way C=

i Hen

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C., t al OESAT l

D=

Em Other

19. Number of Billing items if more space le requ6ted for addit 6cnal baller'0 items, use another
20. Total amount Ltcod on.his Pace L

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

to be billed on 7

thts page

21. Authortr.ation
22. Traveler's Social f 23. For Cnange of Duty Station-Individuals included in this Clairn:

No.

Security No.

9AF00 133-26-8067 c,,,,,,e, no.,, Cni,d,e,, age,12 to 20.

and Parents 2k Road Carefully (If voucher includse any of the "O'*Y** **d 00**'*

followong, merk the appropriste bases):

Vouch 1r includee Shared Cost (Espieln in Part 2.)

O Saa"'*

"* a' cada under 12 consultant Travel Espensee Osimed

25. Traves Advance Vor Ottsce of CONTROttER Use)

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O ^>adoameat et Treves (Ensi in en Port 2.) - '

outstaadia0 ealaace m.ss 8

a =-

e Amount to be applied Compar:lve Cost Statement included '

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.w e vu m". s".o

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Balance to 'emain outstandino

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Leave Taken in conjunction with Trip (Esptain in Porf 2.) -

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fin}I]/sh"'

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2 O t"ca' Trave'

A.1ft.MP "0.4, /.

Q Addnional Vouchers will be Submitted -

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X ;r > du.' 1.:

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Refund Due on Unused Tictist andfor Refund Slip (Explain la Pt. 2) r ln S

Remit *ance Attached in Amt. of 8

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f(

f Q Houee Hunting, l / l

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27. Actual Time in Trev4Ntf '"'W8c'hedide~ho. Vor OttJoe
29. Total Amount Qalmed
30. Total Foreign Costs
31. Not to Traveler (For Ottdes Per 06em Calculation

.,. of CONTROLLEM Use) Included in item 29 of CON TROLLER Use) w,,y,, ,..,,, d, C ,.b M- . N - " '. 't +y ws ,,M s; ; q ) onye, Quartere. '* b,.$

  • 40 T. 4 g,$8"* g p; W DJQ 'tCCb5 2 h $ 2.

p gyr: iclu u;p os se as ach.000vf gj

32. Certshoo Correct Peyment oricredit has not boon receivedN s ' vM qt. p,aylry,p g, w,y.pq m%neFW gg bt.p p.

] .p0 a 807). g ;A N " * " # 4 * " Y Y W/ - I l 4.t '.O 'g, 3,3{fCLA.L,K;;C'jitiM) AK % P.'ti Qt, DC ""i*"T* A

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.ycos,ft./ .f.c .m.,. is,gnature of reeveter)-...~. ~m. .a r-....., 34, Certihed Correct and. Proper for Payment.,.g's. g g. g.j i,y h ]

33. Approved. Long distance telephone celle are certified as paronnary.,,,, !g

-," r e " .-.eo s<> t N. y in the,inearest of the Government ' + ve o.-w < o

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& Clig CipE CperuCG C} WM',Gi' (X3CL4C,ZNQq,,c.g I y!.Q}[y}g g y ~ y c.Dgy 'At '.' pC,jp.tf.60.t3AG[@Gvc if _ Mt qti r A _pp t e o r= e f N,u rst r - [... 4. t, c-t r e ant te; e r'e f *1 "ew't I wmsn,mij fr.sp r &W > (sognature of A~pproverb Ottociel)** /, f(jiete)/ (Authorfred CertityIng Otticer) e-r. (Dete). . ryg

35. %cc5Jentihg Cassification (For Offlee of CONTROLLES Use): r Use):

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i [OtWect i i-

' d .~'ri'h . ' Ob!eci. Y M Il-M I N '[ 'e Li.M - l Qaan Dueell 8 & R Oaos Amount i Geos Detail O & R Oaae Amour $t Case Detail B & R Class Amount n o

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n o.u ,.w , or ~. 4 ,a .p;,.., .v,o S ]W G G1 1W M $1[OU C.1 % 7*,4 3 U.M2KrtJ. K L6CS A p [ [pMy) g ' + m . = n n +.. v., s ..m-. ' MI D N Wp C7M3$ f276usc . 'E WO' t 'W@ ' $0dG M f tX b-F-YN 'OUd MObW 'f MG mh f ' Fraudulent Oaem-Pete4fecation of an item in an esponse account worka's forfeiture of the claim (28 U.S.C. 2514) and may result in a ime of not more than $10.000 or 5'1 . 4mprisonment for not more than 5 years or both (18 U.S.C. 287; id.1001). 'i A

    • lf L o u s".E. Distance telephone calle are included, the approving officer must have been authorized in writing by the head of the Department or Agency to so certify.

escen. m. .,. a... l ~ sus nevenes Onr rArus COpr POn PnivACY ACT srarnueNr,41. p x ~w,y \\ m ? a. - -- p, g-g _y/ M PAYEE' COPY ' T'N u. a m ny m n

/ gg g ;g -- -- --- ~ --. - ~ w.c. ' T AVI L VOUCH ER (PA.T 2) ' ' ' ^ . '?- ~~~"#~~ ~~ ~ ca.,,A,,po'.*e&.d b.,y trau. v.s. SCHEDULE OF EXPENSES ro,nw nee [$ttNRCA mlix 1301 ,:,,,,,,,,for instrrue. ,u a ,fo,,, ,3,, om, s ( AND' AMOUNTS Cl. AIMED -Do Nor Remore ca, ons) . PAT 2 NO. OlV/OPflCE 10 VOUCHER NO. N.m. j DEPART FROM OFFICE DIV. $US-UNIT (DATEb " <. (HOUR) MM DD- /YY: 'l ~70 00 V."GILINSKY 6 29 .79 ~ ^" 22 {,, DATE NAFURE OF EXPENSE AUTHORIZED NUM8ER OF AMOUNT CLAIMEOs '...-. MILEAGE OF MILES g.f. 4.ew, g ~ 'MyY;$,g 75 1r' _n VU Depart Washington (HSt. ) via . qt ~! M .U.S. Government vehicle 2:15 p . ~ ~/T Arrive Middletown, Pa. 4:45 p

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61~.' X& ...,...cf (originally scheduled flight ..y A11eghney-720 - Washington to e 0tp .M 6 Harrisburg - was cancelled. +c...~. s e.e ., >e. : 3 Unused portion of airline .I ticket is returned herewith. b/ZW Tour of Three Mile Island facility - Attend town meeting in Middletown. r' ~b/30 Depart Harrisburg, AL-739 10:35 a Arrive Washington 11:30 a Depart airport via U.S. government vehicle Arrive' Residence 12:15 p .,-., e v . L a....a.ae

'l Gi [ 3 COUROUGt

~ ACTUAL EXPENSES - High Rate Area iof- $45.'00rper daf.MBEEE ~ , v,.n.- n m i; w ', 3 y m

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