Note: Traveler is liable for the value of the tickets issued until all tickets or coupons are properly accounted for on the Travel Voucher




Yüklə 137.16 Kb.
tarix30.03.2016
ölçüsü137.16 Kb.




Form AD-202 USDA) (Rev. 11/96)

TRAVEL AUTHORIZATION/ADVANCE


See Privacy Notice on Reverse

Note: Traveler is liable for the value of the tickets issued until all tickets or coupons are properly accounted for on the Travel Voucher.

1. ACTION CODE (indicate one type only)



E = Establish



C = Cancel




MONTH

DAY

YEAR



A = Amend



V = Advance Only (complete Sections A, E, and F only)

2. AUTHORIZATION DATE

     

  

    

SECTION A - IDENTIFICATION


3. TRAVEL AUTHORIZATION NO.

SOCIAL SECURITY NO.

5. NAME (Last)

(First)

(Middle Initial)

6. AGENCY CODE

     

   

  

    

     

     

     

     

7. AGENCY OON

9. ESTIMATED DATES OF TRAVEL EXPENSES

10. TYPE TRAVEL (indicate one type only) 

  




11. GOVT CC HOLDER

     

FROM

THRU

DM=Domestic

FG=Foreign

FT=Foreign Transfer


GR=Escorted Group

OC=Outside Cont. US

TS=Transfer of Station


RT=Return Travel

OT=Outside CONUS

ToS


8. TRAVELER OON

Month

Day

Year

Month

Day

Year

Yes 

     

     

  

    

     

  

    

No 

12. TRAINING DOCUMENT NO. (For Purpose of Travel Code 3 only)

     

13. OFFICIAL DUTY STATION CITY AND STATE

     

14. RESIDENT CITY AND STATE (if other than Official Station)

     

SECTION B – EMPLOYMENT STATUS (Check the appropriate employment status block.)

 15. PAYROLLED BY NFC

 16. NOT PAYROLLED BY NFC

 17. NEW HIRE

 18. SPECIAL APPOINTEE

 19. NONGOVERNMENT

SECTION C – ITINERARY AND ESTIMATED EXPENDITURES

20. FROM

21. TO

Subsistence

Codes:

P = Per Diem



A = Actual

Subsistence

S = Special

Rate


23. AUTHORIZED EXPENDITURES

CITY

STATE


CNTRY

CODE


CITY

CODE


CITY, COUNTY,

OR REGION


STATE


Lodging + M&IE = Rate X # Days = Estimated Amount

ESTIMATED AMOUNT

CODE

LODGING

M&IE

RATE

# DAYS

     

     

     

     

     

  

 

     

     

     

   

     

  

     

     

     

     

     

  

 

     

     

     

   

     

  

     

     

     

     

     

  

 

     

     

     

   

     

  

     

     

     

     

     

  

 

     

     

     

   

     

  

     

     

     

     

     

  

 

     

     

     

   

     

  

24. PURPOSE OF TRAVEL (give explanation)

     


Total Subsistence

     

  

POV:




Rate




     

  

SECTION D – ACCOUNTING CLASSIFICATION


Rate




     

  

25. Distribute Total Estimated Expenditures from Section C to the applicable Purpose of Travel Code and Accounting Classification Line

Rate




     

  

Rate




     

  

PURPOSE

OF

TRAVEL



CODES

1=Site visit

5=Conference attendance

9=Emergency travel

13=Rest & recuperation

Other (specify)

     

  

2=Information meeting

6=Relocation

10=Other travel

14=Educational

 Unaccompanied Baggage

     

  

3=Training attendance

7=Entitlement/home leave

11=Pre-employment

15=Informal training

 Car Rental

     

  

4=Speech/presentation

8=Special mission travel

12=First post of duty




 Common Carrier Tickets

     

  

PURPOSE CODE

ACCOUNTING CLASSIFICATION

PERCENTAGE

Transportation Mode

     

     

  

     

     

     

Method of Purchase

     

     

  

     

     

     

 Use of non-contract airline




     

     

     

 Excess Fare

     

     

     

 Excess Baggage

     

     

     

 GSA Auto




THESE PERCENTAGES MUST EQUAL

100%

24. Total

     

  

SECTION E – TRAVEL ADVANCE


31. ADVANCE REQUEST METHOD (Select one method only) 



32 ADVANCE MAILING ADDRESS OPTIONS





  




 Salary

Address


 T&A Contact

Point


 Special Address (New hires, special

appointees, and non-govt travelers)



Foreign

Address


 Travel EFT

Account





C = Check or DD/EFT

E = Emergency (Wire)

1. (35)      

T = Travelers Checks

W = Wire Confirmation

2. (35)      

I = Imprest Fund

S = Embassy Issued Adv

3. City (20)      

State (2)   

Zip code (9)      

L = Embassy Collect Advance

33. IMPREST FUND CASHIER




SOCIAL SECURITY NO.

SIGNATURE

27. AMOUNT OF ADVANCE APPLIED FOR









     


$      

   

  

    

28. BALANCE FROM PREVIOUS ADVANCE

34. ADVANCE RECEIVED (Cash or Travelers Checks)

$      

DATE RECEIVED

APPLICANT’S SIGNATURE

TOTAL ADVANCE AMOUNT

Month

Day

Year

     


$      

     

  

    

30. APPLICANT’S SIGNATURE

DATE APPLIED FOR

See Privacy Act Statement

on back

     


Month

Day

Year

     

  

    

SECTION F – AGENCY APPROVAL

35. APPROVING OFFICER’S NAME AND TITLE

AGENCY

36. SOCIAL SECURITY #

37. DATE APPROVED

38. PHONE (area code & no.)

(Last, First, Middle Initial) (Type or Print)

CODE










Month

Day

Year




     

     

   

  

    

   

  

    

     

39. APPROVING OFFICER’S SIGNATURE

40. CONTACT PERSON’S NAME

41. PHONE (area code & no.)

     

     

     


42. REMARKS

     




Upon completion and approval, submit original to:

USDA – National Finance Center, PO Box 60,000, New Orleans, LA 70160





Submit advance applications with original signatures only. Facsimile signatures cannot be accepted.




An advance should be limited to an amount within the prescribed maximum necessary to effectively accomplish the purposes of the Government. An explanation

should be provided in Block 42, Remarks, for an advance authorized in excess of the prescribed maximum.

Privacy Act Notice




The following information is provided to comply with the Privacy Act of 1974 (P.L. 93-579). The information requested on this form is required under the provisions of 5 U.S.C. Chapter 57 (as amended), Executive Orders 11609 of July 22, 1971, and 11012 of March 27, 1962, for the purpose of facilitating authorization action and the request for advance of funds for travel and other expenses to be incurred under administration authorization. The

information contained in this form will be used by the Federal agency officers and employees who have a need to such information in the performance of their duties. Information will be transferred to appropriate Federal, State, local, or foreign agencies when relevant to civil, criminal, or regulatory investigation, or prosecutions. Failure to provide the information required will result in delay or suspension of the processing of this form.


Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©azrefs.org 2016
rəhbərliyinə müraciət

    Ana səhifə