Text

Travel Voucher for V Gilinsky on 800325
	ML19323E515
Person / Time
Issue date:	04/01/1980
From:	Gilinsky V; NRC COMMISSION (OCM)
To:	;
References
	NUDOCS 8005230623
	Download: ML19323E515 (2)
	v • d • e

~-

comperon r Genera, u s.

U S. NUCLEAR REGULATOR COMMISSION TR AVEL VOUCHER (Part 1) e M*1 2.1972

% sHC.1pprnJa 1301 for instrur-timos for tv,mpd< ting ti,is,.,rm) 3 l *. 1 t"'

. J,g,g.

(1)u.%t firmone Carlsons)

F ' it.

j 2. DwissontOff ce 3

s. Ao6 rest Code S. Name of Trsveier (First two sn,tsess cnd est riame) h 9,0 ome j Arnendment fa (leave blank)

Code Voucher No t;-

offca g

v n-7 10 f 70 go bio $oss.

Vl PILIN 5K b '

6. 4. Mamng Address iP O. Bor, Street or Ortecry

b. C.ty, State

c. Zap Code OC% Room 1103, n-Street Washington, D. C.

20555

7. Residence if DiffeIent from item 6

8. Official Duty Statson (Cety. State)

For Traves and Other Espenses DeBleiMh, Md.

Washingcon, D. c.

'U"3 *2h #

j '" 'Of% V6 NRC TO BE BILLED:

11. Number Page 13 Enter

14. Identification

15. Carrier or 16 Points of Travet Covered by

17. Mode and 18.

Amount Each Page No.

apor sate TR No., invoice Rental Car TIR or Period of Car Rental Cia.s of Service to be Billed Consecutively Type No, (Name or (M M DD YY) k

}

Here etc (see Instruc.

Inr* als) feons)

12. Numt;er item TYPE

,r Each item CODES From To Consecutively Becinnin A = TR with "I'g Round Trip B = TR One Way C=

Rantal Car D=

l GEBAT E=

Other

19. Number of A g items if more spEe 6s required for additional bilhng items, use another 20 Total amount Listed on this rege L

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

to be billed on r

this paom

21. AuthorizatiorF"

22. Traveler's Social

/

23. For Change of Duty Station-individuals included in this Claem:

-.. " OAs O'0'C s

l'

...f1.7.16.-8067 x

., ~

Employee No. of Children Ages 12 to 20.

N 24 Read Carefully (if woucher'mcludes any of th,

-x and Parents following. mort the approprsete bores)- E

\\

Q Employee and Spouse VoucMncludes 5'h'ared Cost (Explain in Part 2.)

Sp use No. of Children Under 12 O Coa' suit'aat Trevi Euponses Ctad i E 3 -// O N 3 s i-26. Travel Advance (For Office of CONTROLLER Use)

O Abandonenent of Travel IEsplass in Part 2.)- @Lt..n L L2 i Bam goughtjonarerd,;A t gjy, unf,,c p,p g c,

._ *A I

O Comparat.<ve Cost statemeni. inciud.d.wE sc,... m.'@:' Amovat.O*pplied):Ts: c ;u, oW, :m a erd O ' eave Taxon ia Coaluacison -tin Trip (e o'a,a ia Part 2.): '~ a 8*'*ao*d"*a A

w - e :.m a e a o C /.o rc * '

~

Lcul Travel..

L>

- ? 6

.R " ; [ f, r /C: 26. Vu OHoce of CONTROLLER,USE) Enaminer'a Deducthons p; r. ywp og Add,t;onanvoucners wm be Sub med... m.n e m.c mr

.m

c. n.

, mns une e mpuce Ref und Due on Unused Ticket andlor Refund Siep (Explairt in Pt. 7)

S

_.T O n*='ttaaca Aiiachad 'a ^=i> o' 5 ~ ' l '

.'- 'u.'.y g '~ g'y.~

' ' ' ' ~

^

i Examined by:

W 5te HOM h Actual Time in Travel tar

28. $@edute No IFor Offece - 29. Total Amount Claimed.s l

31. Net to Traveler For Offa a g..

.- 30. Total Fore gn Costs ra's Per D.em Calculation o,,,,,,, a,, c

. of CONTROLLER Use..)~g l

In_cluded in.Jt.e.m 2_9 su y

.... m.

of CONTA.$'f/3 _s.e) c, Ru m

~

El "*~ O 7 x_

m

2. Co,isfied Correc, Paymeni.o, c,ed,t na, noi 3ee,P,ec.,ve, any trec-

. /m c.

Ma'[. 0,2, c'1.adu a.t

... i. y !:,c a :ws. a. ;t

.c w.? u m Oi~u v

m

tvictor cilinahy m:- co ic-a/1/s0 iu tn l,0.3:

, ',, b. _r - iv.

--.e.;

1senature or Travener) n.

- sa m

r. (Dete) 1

33. Appeved. Long distance telephone calls are certifed as necessary

34. Certifed. Correct and Prope. for Feyment in theinfe'est of the Goverrimarit.-"

.._Lvca..**

.4 C% MT i

,a 4L G 0,ch.' CU W M E i'

.~,..

' V.jator.Ci13 ns);f632EO WLUW *M lu W 3 M L'

- % :L I 40' H WA W JM StM W 'l W 2 r

v. -ComM nrioner 4/1/Ao-(Sognature of Approsng Officrat) **.

,.,(Date)

L,

. ] Authorized Certifying Officer)

. (Dete)

35. Accxiuntino Classification (for Office of CONTROLLER Use):

Obtect

.B & R Class

.. Amount Cass Detail B & R Class

-Amount,

Class Detail i B & R Class Amount Class Oct all Object

".i

. " Object.

t

.C A

jQ

{Q B

aN, C

C X

~ M.'

.'L" b'~

s

.u.

.w D

1 itf1

%.m1R dy,i p

' Fraudulent C 4em-Falsifscation of an stem in an expense actnunt works a forfeiture of the claim (28 U.S.C. 2514) and may result in a fine of not tr re than o

510.000 or emprisonment for not more than 5 years or both (18 U.S.C. 287; 6d.1001).

"It Long Distance telephone calls are included, the approving officer must have been authorized in writing by the head of the Department or Agency to so (31 U 5.C. 680a).

see etvERse Or paree COpv FOR Privacy Act sTATeueur PAYEE COPY THIS DOCUMENT CONTAINS l

8005230 O 6 P00R QUAUTY PAGES.

"flff@@f%-vo sor Re stMMMt LW LUARSES AND AMDUNTS CLACED 1

EAGE NO.

DIV/ OFFICE ID YOUCHER NO Name

^ - DEPART FROM OFFICE

)

OtV SU B-UNIT i

(HOUR) g(DATEb --

e.

MM DD YY j

AM V. GILINQKY 03'

'25 ~

50' 1

70 00 PM OATE NATURE OF EXPENSE AUTHORIZED NUMBER OF AMOUNT CLAIMED MILEAGE OF Mit.ES to 80 Rate c

._3/_2J_ Depart H-Street Office via ll:30a U.S. government vehicle Arrive National Depart National I:A-209 12:25p Arrive Raleigh-Durham, N.C.

1:14p Depart Raleigh-Durham EA-512 7:20p Arrive National

'8:06p Depart National via U.S. -

8:10p i

government vehicle Arrive Residence 8:40p No expenses were incurred. =

~

e.

.i

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-t Grana total ( Amt. to be Sh6..nwn in item 29. Part 1) r sn Ruerse of Payee Copy for Privacy Act Statement l

ML19323E515

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