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U S. NUCLEAR HEGULATORY COMMISSI a'. comptroeier ceaerr, u.s. - I TRAMt. VOUCHER (Part 1) . y

Mes 2,1912 N. tC Appemin I , tJinstructlant for compIrti orm) L. * t.,.

. (L ..ot Rrmano GarMns)4 Address C4e S. Name of traveser Varsf two snittais and last name)' ~' '

> l. 2. Divis ont Office L~

$- n v4

V.outher No.. ONom. Ornce

-. . ,7 Code

y " ca c ev. Diana)- e. ,

li O * 70 *Rt 00 o _O 5a-w 'I |GILDSFY^

e. a Ma.i.no Addreae (P.O. so. s,ree, or Ornce) to. c.iy, siate e z cuo,

Oct, Iloosa 1103, II-Stro.et: Washington, D.c. 205'ni t, emeidence it offG~ent from nem e s. otticial outy siai on g,iy Irete) For frevet anf0Eer opensee

- (Qty, state) 9. From (MM 00 YY)Detnesda, MD Washington, D.C. 2_qn.79 | 10. To:2-24-79 )

IMM DD YY

NRC TO BE BILLED: 4

11. Numbo' Pace 13. Enter 14 loontificat6an 15. Carrier or to. Points of Travel Covered by it. Mode and te. AmovedEach Page No. Approor6 ate TH No., invoice Hental Car Tf H or Period of Car Hental Case of Serv 6c4 to to tittledConomoutively Type Code No, (Name or (MM 00 YY) .-

k nonal. . ?t, OR Her e etc (sne Instrue. Initials) ,

. ., .

it. Number stern TYPE From To'

1rf ach stem CODES-

N - N N"a " A / ,

Trip . I.

B.TR'

One. Way

5

Ceb Renrol )' Car ,

av ,

1'

DeGESAT ]

L Em4

.

Other19. Number of t$illing items if more coace is required for addettonal talieng items, use another (20 Total amount

Ito $$% |> Form NHt64, and complete iteme 1 thru S, and 6tems 11 thru 20.oni.be.twi. led on

Listed on this Pagepo >

,

.{ 21. Authorliation 22. .' rave #er's Social 23 For Change of Duty Station-Indev6duale included in thne Gaim: *

6 N Security No.

I 'M-M - R fi n~7 O Cmployee No. of Children Agee 12 to 20.**d Y*' **' '~24. Head Carefutly (It voucher includes any el the [*P'*Y** *** 00****> fonewang, nearn fne appropriate besee). ,

E Voucher includee Shared Cost (Esplade in Part 2.) O 8po"** Na a' ca''d'*a under i2 j

b Consultant Travet Esponene Ctalmed 25. traves Advance vor Othee of CONinoltlR Use)8

Aba ndonenent of Travel (Esplein in Part 2 ) Outstandin0 twance Z ,00,

-

'[ . O Cor'parative Coat statemaai inc'uded ^***a' '' b* ** P"** 717; I

. O Laeve Taken la Conjunction with Trtp (Empton la Part 24 Balance to remala outstanding M , U-

|' * * ' ' ' ' '***'''"'""'""'''''**'"*''''d"*""*

- O Laca' T'''a' /

Additional Vouchers will be SubmittediS

O ae'uad ou* oa unu.ad Tichei endior R. fund sup (e,pi.en en Pt. 2)

Q Ren.ittance Attached in Amt, et 8 |

e ' 'o,,,j/c/77yOH'==Hua"a0>

i ,,am,ne. .,;

b . 27. Actual Time in Travel for 28. Schelute No. (for Othee 29. Total Amount Caimed 30. Total Foreson Costs 31. Het to Treveier vor Orncegi- Por Osem Calcutelion of CONfMOLLER Use) included in item 29 of CONTROLL48 Use)

s osv. Quarwe / c , ,, y y'(* / 32. CIsthtTeJcorrect Payment or credit has not been receeved*"* "

e -

:."G 3 *,

j '^ f.a ~ s V.-@e 0 %,,

,

any tree- / } .

* * A. ,~l.

W [foone et 02 * s |* *

-vm t;1, , a gey) ,

jO8 -

(s ,na,ure of rravoier) costei . , . . . . .p ',

, . 33, Approved. Lane distance telephone calls are certified as necessary 34. Certified Correct and Proper for Payment -a, g / ,, ) ) (, , #, - t

m.+p ,i* in the interest of the Oerernment.' * .

+;c sp9r. M t d ,A$;5+ -

, ,

V_ C $ 1 I Y* R h y ; f r w etftI e et I M n T*

.[ _ (Sognefore of Apposeving OMIctal) **(Dere) f (Authomed Certtrying Orncer) (Dete) - s. -

35. Accounting Onassfication (for Ortsce of CONTMOttEM Use): r Uself - + : y,, ._ [t*

i ONed ONact ONact *Ones Detaal 8 & R Oase Amount . Claes Dataal fl & R Dame Amount Oase Detail n & R Onee Amount

; A 21 30 7021000 *lFIS o e

f% D E F~

D 'Freudu6ent Cinm-Faasification of an item in an esponse account works a forfeature of the claim (28 u.S C. 2S14) and may result 6n a fine of not enore than $10,000 ori: imprisonment for not more than S yeare or botFt (18 u.S.C. 28F; ad.1001). ~ *

'' ll Dettance telephone cans are included. the approving officer must have been authorized in writin0 by the heej of the Department or A0ency to no cer16fyas u s eson). jsea aveAsa or rAyes COPY P04 PAfVACY ACT STATIMENT

._ _

.

% - sone oso yw 353--- - /-ORIGINATING . OFFICE COPY, 4

- -_.u_

_

( n . -we;r n . .. ~ . -YIAVEl. VOUCHE~l (PART 2)

__ , ..-m-Form 64A p.r63 g e -

.

*

c rc.e Aos.umns tne ~ SCHE 0ULE OF EXPENSES.. (See NRCAppemile D01 forinstmesFor

comoera * O*ero. u.5. ison, go, compuerin, uni, ..

"*V''"' AND AMOUNTS CLAIMED -Do Not Remore Car s).

. . .

FAGE NO. OlV/ OFFICE 10 VOUCHER NO. Name DEPART FROM OFFICE .

06V. SUtB UNIT (OATE) (HOUR)

.-- : N.YYMM' 00 ..

AM_ .-q.

1 70- 00 V. GILINSKY 2 20 79 r.,IAJPm -

I DATE NATURE OF EXPENSE AUTHO R e ZEO NUMBER OF AMOUNT CLAIMEO-

,.

MILEAGE OF MILES -

, , , fw; ,.:y .,

j~ ' y c. ( y-- . ..

$9 Rate 4' '"*3' r &

*g 4,-df,{t.aACTUAL TRAVEL CLAIMED .

2/20 Depart office for Dulier. Airport M tc ;

via U.S. Government vehicle 2:00 p.m. gy.gDepart Dulles Airport on u> M

AA #115 4:15 p.m. ,; . f.2, ..

"'? N ' W .-''

Arrive Phoenix, A:|| 7:06 p.m. -

Pick up rental car 7:30 p.m. _ ,- gM-

~

.. ., ,

2/21 Attend Palo Verde _Licensinq " 1. I.

Hearing -,

Return rental car 2/23h97:16 |'

3

ACTUAL TRAVEL NOT CLAIMED ~I.~'

'

T/21 capart Pnoenix, AZ on TWA #150 11:00 p.m.'

Arrive Albuquerque, NH 1:00 a.m.

2~/22 ' Annual leave

2713- Annual leave ;

( 2/24 Depart Albuquerque, HM |on #98 AA 10:30 a.m.

'

Arrive Dallas-Ft. Worth 12:54 p.m.Depart Dallas-Ft. Worth on'

AA #152 1:50 p.m.Arrive Dulles Airport 5:30 p.m.Depart 2i v rt via U.S.

Goverzunant vehicle 6:00 p.m. . g,z

Arrive residence 6:45 p.m. .. .

'

.c .

/.-d#

COMPARATIVE TRAVEL CLAIMED . ~ <*

2/21 Wou1d haVeTiAd to ramalA~1n Phoenix over--~ ~ ~

., y,

ni.qht due to no available flights to N, ~ " 54 9.

.1coincide with and of meeting schedule. ..

X.Q*' W '

Would have taken first available flight<

mydf -~

next morning.to return to Washington. - . %,wmw .qqn 2- .

. . - . . . ...~n2/22 Depart Phoenix, As on AA #112- 9:35 a.m. ,j. w, m gig e

en im - --

Arrive Dulles Airport 3:39 p.m.g g a.W .w .fDepart airport via U.S. Govern-

meng vehicle 4:00 p.m. - NE- Mhal ;

Arrive residence 4:45 p.m. ; yE., p r 9 ..ad. ; .a # .. c. u .

3.'s

. O' 4 . ..;.- hd. '.-

'Y|Wf N &e f Sfe ' DD5' '-

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; .N' ' !'I * #$$ C.

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7*x 3%t y. ;ggn:. . ,,.,w,.,g~, - ,,

|? u ws.n,|py -4 Q"|;fr|-;* - Q'.;,

*,.

. ..f,ed . . .d...,_L; Grand total (Amt to De Snown in item 29, Part I) E-ki '[c N 'N, y..1W. , . ~ - s m. , s. . .

m

See coverse of Payee Copy for' Privachet Statement ., /. . ORIGibAilNG55FbCbbbi'Y ;-l' Nbh}t

, , , .

amm.eg. wgg- .m . - ~- a- - . . _ . - - _ _ _

. . _ . _ , . . _ . _ . . . .. . .~ . . a . .

. T''AVEL VOUCHEQ (PA'lT 2) ..., ., -. ,. ,_.e f . _ , ., - ... . . .. . .. , -

- (see NRC A pesadt.e 1,,3,0,, thor,instrsue.compir.v.,n a.A p 74 3.'..n.r c.au.ra. v.s.q SCHEDULE OF EXPENSESNec conm as , -

,jo,,, /,, ,,,, ,, ,3 , fo,,,,Faso A s snn

"* # # ' " " 0 AND AMOUNTS CLAIMED -oo Not Remore carbons)< %|*e ..

CAc3 NO. OtV/ OFFICE IO VOUCHER NO. Name DEPART FROM OPPICEO t v, SUS-UN6T (OATE) (HOUR)

MM DO Y.Y .. .

.f>.,. AM

2 '70- 00 V. GILINSKY '2 20 79 r;a .LAI PM*

CATE NATURE OF EXPENSE AUTHOHI *ED NUMHER OF AMOUNT Ct. AIMED - .-'a'. J.4D7; o,f.JMILE AG E OF Mat.ES

. ,c - f

.i,79 -

'3.~

~

.v Rai. < - ... .M,Avh.-. ...

t.

BER DIEM u.- 'r <W .

.y %.67/2u 1/2 aay e 9Js.uu pd). d W = 617 30"

~.'p,. .._,r,.,- -... .

sh , sq * n.

- -2/21 --l- day i G35.00 per day -535.00 , ,, ,.-

- . . ..,

' '

2/22- 3/4-day e 435.00 pe:raayN 720 2D ..z - 7,

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' .. dXys e vs>.uu perdXy 78 75 .,Turn - z-1/4.

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sw:L 9: Wp/4 Ctand total (Amt. to be Shown in item 29, Part I)-

l. - + * M ,* :r s W - > * *. ; M, ..w w ,, -p : # p&.r- :2. , m. ' nte: u :~~' 2 n. . 1.% u; :.. w~ :,;.::a ,,.,,,m.,.. . . . .

c

n, y 'Ipg, .;y, ' 1.5y- , N4.w(|, m,:b,.y.hk,';.. ORIG.lNATING - 0FFICE COPYf "@;M.79

s a or Pay.. Copy for Prfmy Act Statement (.. ! ' - :W.s.1.y n.~ J W .2,,+ m.. u .e,, w :: . , e ,.- < .v. -m: mus:s.- _ ..u, , .. . n,.,p.m g .,r gggg.g

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