STATEMENT OF TRAVEL PERFORMED FOR WHICH REIMBURSEMENT. IS NOT CLAIMED 
BY TRAVELER 
DATE OF 
TKAVEL 
NO. OF TRANS- 
PORTATION 
REQUEST OR 
SPEEDOMETER 
READING 
SB 
SI«2^2 mmmml IJ 0 , 
FROM— 
TO— 
VIA 
(Kind of carrier 
or vehicle)* 
Bravturermo, Texas 
ittllK}a» Canal Zam 
and re1»una 
Itarah 89 31-2983 lUsrai, Florida 
May 2 Balboa, Canal Zone 
4 51-8^5 Hops 
• ’- 4 . 
IfeMbington, D.c* 
iastera 
iirUnsa 
Fan ssmTiem 
Airvaya 
Sastam 
Airllsaa 
Pi 
lallNw, Csaal 20m 
B.H. 
n ft 
CLASS OR 
MILEAGE t 
Ist Cl. 
lafc Cl. 
AMOUNT 
# 86.40 
232«87 
80.61 
1*30 
1.30 
♦Railroad, steamship, airplane, bus, etc. 
fAbbreviate class of service or accommodations used. Railroad: F, first class; I, intermediate class; M, mixed class; C, coach; P, Pullman accommodations; DR, drawing room; 
OP, compartment; BR, bedroom; SOS, single occupancy section; SEC, section; LB, lower berth; UB, upper berth; S, seat. By other mode: Number of miles traveled. 
INSTRUCTIONS 
l^The provisions of the travel regulations must be strictly observed in order to avoid suspensions and disallowances in the accounts. 
2 C When more space is required for itemization of the account, use continuation sheets (standard forms 1012b — Revised and 
1012c — Revised) and fasten together in upper left-hand corner. 
3. As many copies of the approved memorandum voucher may be'" made as required for administrative purposes. 
V. a. GOVKRNIIKNT FRINTINa OFFICB 
10 — 1664a 
