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DOC 0000017453
Page 16
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7 SECRET.
: _Cehea Fitted in)
TT = COST nrg
SCHEDULE OF EXPENSES AND ITINERARY OF TRAVELE Rg
DESCRIPTION oF EXPENDITURE AND DETAIL oF ITINERARY —
(Deduct % from the applicable per diem for each
meal and lodging furnished without charge)
Hk aay pe per Glen €-6 ; =
—3-daye-pa soos © 612,00" SS
| CHECK ONE: TOTALS, _ [essa FORWNRG i 4S, 9) vi)
i = < —— a me me eg I SS a Ss a _ _ a
Es 3g . mee USE anal SHEET T FOKM NO. 22a, IF ADDITIONAL SPA REQUIRED e
ol at pene a ge ge DRE ANE TPE ELT PRE METLT E S OR I RT eEE ET
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