PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. Section 5701, 37 U.S.C. Sections 404 - 427, 5 U.S.C. Section 301, DoDFMR 7000.14-R, Vol. 9, and E.O. 9397.
PRINCIPAL PURPOSE(S): This record is used for reviewing, approving, accounting, and disbursing money for claims submitted by Department
of Defense (DoD) travelers for official Government travel. The Social Security number (SSN) is used to maintain a numerical identification filing
system for filing and retrieving individual claims.
ROUTINE USE(S): Disclosures are permitted under 5 U.S.C. 552a(b), Privacy Act of 1974, as amended. In addition, information may be
disclosed to the Internal Revenue Service for travel allowances, which are subject to Federal income taxes, and for any DoD "Blanket Routine
Use" as published in the Federal Register.
DISCLOSURE: Voluntary; however, failure to furnish the information requested may result in total or partial denial of the amount claimed.
PENALTY STATEMENT
There are severe criminal and civil penalties for knowingly submitting a false, fictitious, or fraudulent claim (U.S. Code, Title 18, Sections
287 and 1001 and Title 31, Section 3729).
INSTRUCTIONS
ITEM 1 - PAYMENT
ITEM 15 - ITINERARY - SYMBOLS
Member must be on electronic funds (EFT) to participate in split
15c. MEANS/MODE OF TRAVEL (Use two letters)
disbursement. Split disbursement is a payment method by which
you may elect to pay your official travel card bill and forward the
Automobile - A
GTR/TKT or CBA (See Note) - T
Motorcycle - M
Government Transportation
- G
remaining settlement dollars to your predesignated account. For
Bus
- B
Commercial Transportation
example, $250.00 in the "Amount to Government Travel Charge
Plane
- P
(Own expense)
- C
Card" block means that $250.00 of your travel settlement will be
Rail
- R
Privately Owned
electronically sent to the charge card company. Any dollars
Vessel
- V
Conveyance (POC)
- P
remaining on this settlement will automatically be sent to your
predesignated account. Should you elect to send more dollars than
Note: Transportation tickets purchased with a CBA must not be
you are entitled, "all" of the settlement will be forwarded to the
claimed in Item 18 as a reimbursable expense.
charge card company. Notification: you will receive your regular
monthly billing statement from the Government Travel Charge Card
15d. REASON FOR STOP
contractor; it will state: paid by Government, $250.00, 0 due. If you
forwarded less dollars than you owe, the statement will read as: paid
Authorized Delay
- AD
Leave En Route
- LV
by Government, $250.00, $15.00 now due. Payment by check is
Authorized Return
- AR
Mission Complete - MC
made to travelers only when EFT payment is not directed.
Awaiting Transportation - AT
Temporary Duty
- TD
Hospital Admittance
- HA
Voluntary Return - VR
REQUIRED ATTACHMENTS
Hospital Discharge
- HD
1. Original and/or copies of all travel orders/authorizations and
amendments, as applicable.
ITEM 15e. LODGING COST
2. Two copies of dependent travel authorization if issued.
Enter the total cost for lodging.
3. Copies of secretarial approval of travel if claim concerns parents
who either did not reside in your household before their travel and/or
ITEM 19 - DEDUCTIBLE MEALS
will not reside in your household after travel.
Meals consumed by a member/employee when furnished with or
4. Copy of GTR, MTA or ticket used.
without charge incident to an official assignment by sources other
5. Hotel/motel receipts and any item of expense claimed in an
than a government mess (see JFTR, par. U4125-A3g and JTR, par.
amount of $75.00 or more.
C4554-B for definition of deductible meals). Meals furnished on
6. Other attachments will be as directed.
commercial aircraft or by private individuals are not considered
deductible meals.
29. REMARKS
a. INDICATE DATES ON WHICH LEAVE WAS TAKEN:
b. ALL UNUSED TICKETS (including identification of unused "e-tickets") MUST BE TURNED IN TO THE T/O OR CTO.
DD FORM 1351-2 (BACK), MAR 2008
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