STATEMENT OF TRAVEL PERFORMED FOR WHICH REIMBURSEMENT IS NOT CLAIMED 
BY TRAVELER 
NO. OF TRANS- 
DATE OF 
TRAVEL 
PORTATION 
REQUEST OR 
SPEEDOMETER 
FROM— 
TO— 
VIA 
(Kind of carrier 
or vehicle)* 
CLASS OR 
MILEAGEf 
AMOUNT 
—1941_ 
Fob, 27 
SI-2,914 
Mew York, N. T. 
3arranquilla, 
Colombia 
United 
Fruit Co. 
1st Cl. 
#121.00 
Mbh. 2 
SI-2,915 
Washington# D.C. 1 
law York, H. Y. 
Pa. R. R. 
1st Cl. 
6.70 
" 2 
SI-2,916 
Washington, D.C. 
lew York, N. Y. 
Pullman 
L seat 
1.35 
Hay 13 
*31-2,917 
Curaeao, N.W.I 
Stew York, ». Y. * 
Grace Line 
1st Cl. 
160,00 
* 22 
SI-2,918 
new York, H. Y. 
Washington, D.C. 
Pa. R. R. 
1st Cl. 
6.70 
• 22 
SI-2,919 
Raw York, N. Y. 
?adbington, D.C« 
Pullman 
L lower 
2,65 
t 
. .. 
#298,40 
- 
» 
*> 
* 
• 
X 
* 
* 
* * 
+- 
* 
+ 
X 
* 
■* 
y 
T 
f* 
4 
* 
’Railroad, steamship, airplane, bus, etc. 
*. fAbbreviate class of service or accommodations used. Railroad: F, first class; I, intermediate class; M, mixed class; O, coach; P, Pullman accommodations; DR, drawing room; 
CP r compartment; BR, bedroom; SOS, single occupancy section; SEC, section; LB, lower berth; UB, upper beyth; S, seat. By other mode: Number of miles traveled.. 
- ' 4 ■ 
INSTRUCTIONS 
1. fcie provisions of the travel regulations must be strictly observed in order to awoid suspensions and disallowances in the accounts. 
2. 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. 
U. 8. GOVERNMENT PRINTING OFFICE 10 - 1664a ^ 
Standard. Form No. 1012a—Revised 
co»fr^”cSSru. s . VOUCHER FOR PER DIEM AND/OR REIMBURSEMENT n o Von No 
a,a«„ £ NO.« 0F EXPENSES INCIDENT TO OFFICIAL TRAVEL Bureau No. _ 
(Statement of account must be completely filled in by payee prior to signature, and there must not be any erasure or alteration unless initialed or signed by him) 
u s aaithsoaias Institution,U.S.Hatioaal Museum, 
(Department, bureaii^j^csta^ishm^l^^^^ 
General Accounting Office 
PREAUDIT 
1 Certified for payment in the 
sum of $.... 
Comptroller General or 
the United States 
By.—.. 
THE UNITED STATES, Dr., To 
¥. S. National Museum, WashiagWf'Sic. 
Official Headquarters__ 
Domicile_1__ Residence_ 
(For use of Postal Service only) 
PAID BY 
188-100 
(For use of Paying Office) 
FOR PER DIEM in lieu of subsistence, mileage for personally owned motor vehicle, and/orJ|hEn^tj^RSEME 
of t r^el anther expens ^ paid by me in the discharge of official duty from___ 
to ---, 19—-, as per itemized statement within, under authority No_^ , dated 
copy of which is attached,* or has been previously furnished with voucher No._, paid 
19-., by- 
(Name of disbursing officer) 
L9-, 
% 
(Payee will NOT use this space) 
Differences_ 
Account verified correct for.. 
(Signature or initials).. 
AMOUNT 
Dollars Cents 
520*35 
MEMORANDUM 
ACCOUNTING CLASSIFICATION (For completion by administrative office) 
Appropriation, Limitation 
or Project Symbol 
33-1911004,004 
Appropriation Title 
Ooofer&t&oB with the Aawrican 
to- 
3Bitb*>nia» Institution), 1941 
Limitation or Project 
Amount 
580.S5 
Appropriation 
Amount 
520.S5- 
Allotment Symbol 
Amount 
-aTi 
$ Jr 
' 23*. 
Encumbrance 
Liquidated 
Cost Account 
Object of Expenditure 
f Check No__, dated 
Paid by < 
l Cash, $_ 
on 
., 19. 
19_, for $. 
SIGN 
ORIGINAL 
ONLY 
580.35 
I on Treasurer of the United States 
[ in favor of payee named above. 
(Signature of payee) 
•If there was no prior authority state circumstances which rendered securing prior authority impracticable. 
10—1604 a 
