Sf Form 1038 - Advance Of Funds Application And Account printable pdf download

1. TYPE OF ADVANCE

2. TYPE OF TRAVEL

ADVANCE OF

CASH

TEMPORARY

FUNDS

3. NAME (Last, first, middle initial)

4. ACCOUNT NO.

APPLICATION

5. TELEPHONE NUMBER(S)

6. SOCIAL SECURITY ACCOUNT NO.

CHECK

PERMANENT

AND ACCOUNT

In compliance with Privacy Act of 1974 the following information is

7. DEPARTMENT OR ESTABLISHMENT

8. BUREAU, DIVISION OR OFFICE

provided: Solicitation of the information on this form is authorized

by 5 U.S.C. Chapter 57 as implemented by the Federal Travel

Regulations (FPMR 101-7), E.O. 11609 of July 22, 1971, E.O.

11012 of March 27, 1962, and E.O. 9397 of November 22, 1943.

APPLICATION 

 (For completion by applicant)

The primary purpose of the information is to facilitate the review,

e. BALANCE DUE U.S.

An advance of funds is hereby requested for travel and other

approval, accounting, and advancement of funds for travel and

FROM PREVIOUS

expenses to be incurred by me.

certain relocation allowance expenses to be incurred under

ADVANCE

appropriate administrative authorization.

The requested in-

a. UNDER AUTHORIZATION NUMBER

DATE OF AUTHORI

f. AMOUNT HEREIN

formation will be used by officers and employees of this agency

ZATION

APPLIED FOR

who have a need for such information in the performance of their

official duties. The information will be disclosed to appropriate

From

Federal, State, local or foreign agencies, when relevant to civil,

c. TRAVEL PERIOD

TOTAL

criminal, or regulatory investigations or prosecutions, or when

pursuant to a requirement by this agency in connection with the

d. MAIL CHECK TO

OFFICE

RESIDENCE

Note: Outstanding advances not fully recovered

firing or firing of an employee, security clearances, or other

(Give address  number, street, State, ZIP code)

by deductions from reimburse-ment vouchers

investigations of the performance of official duty while in

must be promptly repaid.

When travel is

canceled or indefinitely postponed, the full

Government service.

Your Social Security Number (SSN) is

amount of any out-standing advance shall be

solicited for use as an employee identification number. Disclosure

repaid immedi-ately.

of the requested information is voluntary; however, failure to

provide the information required may result in delay or suspension

DATE

APPLICANT

of your advance of funds request.

3/9/01

SIGN HERE

SIGNATURE AND TITLE OF APPROVING OFFICIAL

DATE APPROVED

11. APPROPRIATION TO BE CHARGED

10. APPROVAL

12. REMARKS

13. CASH PAYMENT RECEIVED

DATE

STANDARD FORM 1038

13. RECORD OF ACCOUNT

NAME

ACCOUNT NO.

(Optional)

TRANS-

TRAVEL PERIOD

REFERENCE

ADVANCE ACCOUNT

MEMO OF APPROVED EXPENSES VOUCHER

ACTION

(Schedule or

AMOUNT PAID

voucher number)

DATE

FROM

VOUCHER TOTAL

ADVANCED

REPAID

BALANCE DUE

EMPLOYEE

REMARKS

STANDARD FORM 1038 BACK

In lieu of STANDARD FORM 1038

Sf Form 1038 - Advance Of Funds Application And Account

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