Dd Form 1351-2 - Travel Voucher Or Subvoucher Template
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1
2Read Privacy Act Statement, Penalty Statement, and Instructions on back before completing
TRAVEL VOUCHER OR SUBVOUCHER
form. Use typewriter, ink, or ball point pen. PRESS HARD. DO NOT use pencil. If more
space is needed, continue in remarks.
SPLIT DISBURSEMENT:
The Paying Office will pay directly to the Government Travel Charge Card (GTCC) contractor the portion of your reimbursement
1. PAYMENT
representing travel charges for transportation, lodging, and rental car if you are a civilian employee, unless you elect a different amount. Military personnel are required
Electronic Fund
to designate a payment that equals the total of their outstanding government travel card balance to the GTCC contractor.
Transfer (EFT)
NOTE: A split disbursement is only necessary when a GTCC is used while on official travel for the Government.
$
Payment by Check
Pay the following amount of this reimbursement directly to the Government Travel Charge Card contractor:
2. NAME (Last, First, Middle Initial) (Print or type)
3. GRADE
4. SSN
5. TYPE OF PAYMENT (X as applicable)
Member/Employee
TDY
6. ADDRESS. a. NUMBER AND STREET
b. CITY
c. STATE
d. ZIP CODE
PCS
Other
Dependent(s)
DLA
e. E-MAIL ADDRESS
10. FOR D.O. USE ONLY
8. TRAVEL ORDER/AUTHORIZATION
7. DAYTIME TELEPHONE NUMBER &
9. PREVIOUS GOVERNMENT PAYMENTS/
a. D.O. VOUCHER NUMBER
NUMBER
AREA CODE
ADVANCES
11. ORGANIZATION AND STATION
b. SUBVOUCHER NUMBER
13. DEPENDENTS' ADDRESS ON RECEIPT OF
12. DEPENDENT(S) (X and complete as applicable)
c. PAID BY
ORDERS (Include Zip Code)
ACCOMPANIED
UNACCOMPANIED
c. DATE OF BIRTH
a. NAME (Last, First, Middle Initial)
b. RELATIONSHIP
OR MARRIAGE
14. HAVE HOUSEHOLD GOODS BEEN SHIPPED?
d. COMPUTATIONS
(X one)
YES
NO (Explain in Remarks)
c.
d.
15. ITINERARY
e.
f.
MEANS/
REASON
LODGING
POC
a. DATE
b. PLACE (Home, Office, Base, Activity, City and State;
MODE OF
FOR
COST
MILES
City and Country, etc.)
TRAVEL
STOP
DEP
ARR
DEP
ARR
DEP
ARR
DEP
ARR
DEP
ARR
DEP
e. SUMMARY OF PAYMENT
ARR
(1) Per Diem
DEP
(2) Actual Expense Allowance
ARR
(3) Mileage
16. POC TRAVEL (X one)
OWN/OPERATE
PASSENGER
17. DURATION OF TRAVEL
(4) Dependent Travel
18. REIMBURSABLE EXPENSES
(5) DLA
12 HOURS OR LESS
a. DATE
b. NATURE OF EXPENSE
c. AMOUNT
d. ALLOWED
(6) Reimbursable Expenses
0.00
(7) Total
MORE THAN 12 HOURS
BUT 24 HOURS OR LESS
(8) Less Advance
0.00
(9) Amount Owed
MORE THAN 24 HOURS
(10) Amount Due
19. GOVERNMENT/DEDUCTIBLE MEALS
a. DATE
b. NO. OF MEALS
a. DATE
b. NO. OF MEALS
20.a. CLAIMANT SIGNATURE
b. DATE
c. REVIEWER'S PRINTED NAME
d. SIGNATURE
e. TELEPHONE NUMBER
f. DATE
21.a. APPROVING OFFICIAL'S PRINTED NAME
b. SIGNATURE
c. TELEPHONE NUMBER
d. DATE
22. ACCOUNTING CLASSIFICATION
23. COLLECTION DATA
26. TRAVEL ORDER/
24. COMPUTED BY
25. AUDITED BY
27. RECEIVED (Payee Signature and Date or Check No.)
28. AMOUNT PAID
AUTHORIZATION POSTED BY
DD FORM 1351-2, MAY 2011
PREVIOUS EDITION IS OBSOLETE.
Exception to SF 1012 approved by GSA/IRMS 12-91.
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