NAV. S. AND A. FORM 913—REV.
Form Prescribed by
Comptroller General, U. S.
May 17, 1945
VOUCHER FOR REIMBURSEMENT
FOR
EXPENSES INCIDENT TO DEPENDENTS TRAVEL
MAIL TO BUREAU OF NAVAL PERSONNEL, WASHINGTON 25, D. C.
D. O. VOU. No. 3375
BU. VOU. No.
THE UNITED STATES, DR.
TO (PRINT)
NEWHOUSE, Delbert C. Lt. USN 17723
(Last Name) (First) (Middle) (Rank or Rating) (Fix or Service No.)
OFFICIAL ADDRESS
Office of Bureau of Astronautics General Representative,
Central District, Wright Field, Dayton, Ohio
J. A. REBENITISCH
Symbol 540415
NCDO Great Lakes
SEP 15 1948
J. SCOTT
Symbol 52-527
(For use of Paying Officer)
AMOUNT
DOLLARS | CENTS
$ 202 08
FINISHED FILE PERS 811
MEMORANDUM
202.08 J. SCOTT, Officer in Charge 52-527
By Alice C. Gibbons, Agent Cashier
PAID BY CHECK NO.
526944
ACCOUNTING CLASSIFICATION (For completion by Administrative Officer)
APPROPRIATION, LIMITATION OR PROJECT SYMBOL
APPROPRIATION TITLE
1790813
TRNP-1949 020 74130
FARE AUTHORIZED
FROM
TO
RAIL
PULLMAN
TOTAL
$
CERTIFICATION OF CLAIMANT (FILL IN ALL BLANKS BELOW WHERE APPLICABLE)
Payment is requested for transportation for travel performed by the following, who were my dependents on the effective date of orders directing this change of station.
NAME
RELATIONSHIP
DATE OF BIRTH OF CHILDREN
Norma Isabel Newhouse
Wife
Delbert Carroll Newhouse
Son
6/28/38
Anne Lisbet Newhouse
Daughter
3/14/40
at 412 Third St., NHA #1,
Honolulu 50, T.H.
I certify that my dependents were located (City and State) when orders directing detachment from my old permanent station were received, and departed from that place on (date) 1 July 1948; Arrived Alameda, California 16 July 1948; Departed Alameda, California 16 July 1948 and arrived at Dayton, Ohio on (date) 24 August 1948. I further certify that my dependents traveled at my own expense, and that the child (children) named above is (are) the legitimate child (children) of the officer or man concerned. (IF CHILD (CHILDREN) IS (ARE) STEP OR ADOPTED, FILL IN CERTIFICATE ON REVERSE SIDE.)
I certify that the travel covered by this claim represents the entire travel of all my dependents which has been or will be made on this change of station except as follows: No exceptions
*Reimbursement requested herein is (is not) in accordance with par. 3 of SecNav letter of 23 Dec. 1943.
*I hereby designate as point to which transportation of dependents is desired.
I certify that this account and schedule annexed are true and just in all respects; that payment therefor has not been received; and that my statements of travel correctly reflect travel performed by my dependents.
SIGN ORIGINAL ONLY
PAYEE
Delbert C. Newhouse,
Lieutenant
U. S. N.
DATE
1 Sept. 1948
RANK OR RATING
*If applicable see Instruction 1.
16—44896-1
(Instructions on reverse side of form.)
COPY