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
TO BUREAU OF NAVAL PERSONNEL, WASHINGTON 25, D. C.
D. O. VOU. No. 3638
BU. VOU. No. 3375
PAID BY
J. A. REBENTISCH
Symbol 540415
NCDO Great Lakes
SEP 15 '48
J. SCOTT
Symbol 52-527
(For use of Paying Officer)
AMOUNT
DOLLARS | CENTS
--- | ---
$ 202.08
PAID BY CHECK No.
526944
THE UNITED STATES, DR.
TO (PRINT) NEWHOUSE, Delbert C. Lt. USN 177283
(Last Name) (First) (Middle) (Rank or Rating) (File or Service No.)
OFFICIAL ADDRESS Office of Bureau of Aeronautics General Representative,
Central District, Wright Field, Dayton, Ohio
MEMORANDUM
202.08 J. SCOTT, Officer in Charge 52-527
By Alice C. Gibbons, Agent Cashier
ACCOUNTING CLASSIFICATION (For completion by Administrative Officer)
APPROPRIATION, LIMITATION
OR PROJECT SYMBOL
1790813
APPROPRIATION TITLE
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
I certify that my dependents were located Honolulu 50, T.H. (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 (City and State) 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. 13 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,
DATE 1 Sept. 1948
RANK OR RATING Lieutenant U. S. N.
*If applicable see Instruction 1.
16—44896-1
(Instructions on reverse side of form.)
DUPERS