ITEMIZED SCHEDULE OF TRAVEL AND OTHER EXPENSES
1. Date and hour of departure from official headquarters _________________________ (Date) _________________________ (Hour)
2. Give duty status on first day of voucher period:
*Arrived at _________________________ on _________________________, 19____, for temporary duty for approximate period _________________________
Approximate date of return to official headquarters _________________________, 19____
3. †State authorized per diem in lieu of subsistence, $_________________________
4. †State authorized allowance for actual subsistence expenses: Not to exceed $_________________________ per day.
5. Where for traveler’s personal convenience or through the taking of leave there is interruption of travel, deviation from the direct route, or where traveler delays at a place other than post of duty, a statement showing the facts should appear on the voucher.
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*If authority provides for travel to more than one point, time of arrival and departure from each should be stated in the body of the account in chronological order.
†If more than one rate of allowance is authorized, full statement of application of each rate must be given in some convenient place on this voucher.
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DATE
CHARACTER OF EXPENDITURE
(To be itemized by the day and fully explained)
SUB-VOU. NO.**
AMOUNT
NOTATIONS
(Payee must not use this column)
SUBSISTENCE
OTHER
1946
Reimbursement for cost of transportation of my dependents wife and children on permanent change of duty from Aviation Supply Depot, Phila Pa. to Aviation Supply Depot, P. R.
I certify that Norman I. Newhouse is my lawful wife, and that Delbert Carroll Newhouse, and Anne Lisbet Newhouse, age 8 and 6 years, male and female born June 28, 1938 and March 14, 1940 are my legitimate children.
I, Delbert C. Newhouse certify that Delbert Carroll Newhouse and Anne Lisbet Newhouse are my legitimate children, will be 9 and 7 years of age at next birthday, and are members of my household; that said children are not possessed of property or income adequate for their support and education; that they are not the beneficiary, either directly or through others, of any trust or estate entitling their income adequate for their support and education; that said children are in fact now and at all times solely dependent on me; that in all respects I maintain the children at my own expense and from my own resources and am not reimbursed therefor directly or indirectly in any manner or form whatsoever, and that evidence of the children’s dependency upon me and my maintenance of them have been filed with my pay accounts and is hereby made a part hereof.
I certify that the location of my dependents named herein on August 7, 1946 the date I received my orders was Philadelphia, Pa.
Travel of dependents named herein was made from Phila Pa. to San Francisco, California.