◆ SpookStack

1. DEPARTM OR ESTABLISHMENT, 2. TYPE OF TA 3. VOUCHER NO. Y TRAVEL VOUCHER BUREAU DMSION OR OFFICE (1 Temporary (Read the Privacy Act U. S. Department of Justice . PERMANENT CHANGE |4. SCHEDULE NO. Statement on the back} FBI « OF STATION 6. PERIOD OF TRAVEL Q a. NAME (Last, first, middle initial) ~ - b. SOCIAL SECURITY NO. s a. FROM b. TO 2 PISTEY, EDMUND J. 12/31/83 = ¢. MAILING ADDRESS (/nclude ZIP Code) d. OFFICE TELEPHONE NO. |7, TRAVEL AUTHORIZATION 7 WASHINGTON, D.C. a. NUMBER(S) }b. DATE(S) u 271-62 6/1/62 Fs e. PRESENT DUTY STATION f, RESIDENCE (City and State) NEW ORLEANS NEW ORLEANS 10. CHECK NO. TREE See CASH PAYMENT REgeteT_______it PAID BY a. Outstanding a. ————— RECEIVED bd. Amount to be applied b7 E Amount due Government c. PAYEE’S pone {Artached: DO Check 0 Cash) - Balance outstanding 12. BONES OMT ATION | hereby assign to the United States any right | may have against any parties 1n connection with reimbursable > Traveler’s Initials REQUESTS, OR transportation charges described below, purchased under cash payment procedures (FPMR 101-7) TRANSPORTATION ODE TICKETS, IF PUR- 5 POINTS OF TRAVEL SED WITH.CASH AGENT'S CLASS OF ae by number below| VALUATION SERVICE DATE ang attach passenger OF TICKET AND ACCOM- ISSUED FROM TO coupon; if cash is used (Initials) | MODATIONS show claim on reverse fa) (c} (a) le} (t) side.) VOUCHER "iT IS CERTIFIED | THAT AllL EXPENSES |CLAIMED IN THIS 2558" wy TO WYRE & Cw se ct > THe — an (DATE) 13. ! certify that this voucher.1s true and corregf to the best of my knowledg@wadsbelief, and that payment or credit has not been received by mg applicable, per dienf claimed igHasfifaaashe average cost of lodging incurred durjng the period ‘covered by | this vouche A / TRAVELERS a DATF AMOUNT eZ G(x crameoR |s| NOTE: Falsification of an item in agexpense account works a forfe 514) and may result in a fine of not more than $10,000 .. impri. faent ‘or not more than 5 years tf{r both (18 U.S.C. 2 . 1001). 17. FOR FINANCE OFFICE USE ONLY COMPUTATION a. OIFFER- 14. This voucher is approved. Toresdi4tance telephone calls, if any, are certified as necessary in the interest of the Government. (NOTE: /f long distance telephone calls are included, the approving official m een authorized in writing by the head of the department or agency t&so certify(31 U.S.C. 680a).) Ss ’ ENCES, IF ANY APPROVING DAT (Explain OFFICIAL ‘ amount) SIGN HERE JE fe 15. LAST PRECEDING Vpocr ER PAID UNDER SANEYTRAVEL AUTHORIZATION YEAR . Certifier’s initials: 8. THIS VOUCHER IS CERTIFIED CORRECT AND PROPER FOR PAYMENT APPLIED TO TRAVEL ADVANCE wa * (Appropriation symbol): AUTHORIZED . CERTIFYING DATE OFFICIAL ee SIGN HERE d. NET TO TRAVERSED. 18. ACCOUNTING CLASSIFICATION 1012-116 NSY 7540-00~634-4.180 STANDARD FORM 1012 (REV. 10-77) A pe am f fem = f Zt ~ «. ae’ Prescribed by GSA, FPMR (41 CFR) 101-7 ‘ 4 : * oe . tl ~s * % ~ -* - b. TOTAL VERIFIED CORRECT FOR CHARGE TO APPROPRIATION