Read Privacy Act Statement, Penalty Statement, and Instructions on back before completing
TRAVEL VOUCHER OR SUBVOUCHER
form. Use typewriter, ink, or ball point pen. PRESS HARD. DO NOT use pencil. If more space
is needed, continue in remarks.
2. TYPE OF PAYMENT (X as applicable)
1. PAYMENT
3. FOR D.O. USE ONLY
Member/
Electronic Fund Transfer (EFT)
Payment by Check
PCS
a. D.O. VOUCHER NUMBER
TDY
Employee
$
Split Disbursement:
Amt to Govt Tvl Charge Card
Dependent(s)
DLA
Other
4. NAME (Last, First, Middle Initial) (Print or type)
5. GRADE
6. SSN
b. SUBVOUCHER NUMBER
7. ADDRESS. a. NUMBER AND STREET
b. CITY
c. STATE
d. ZIP CODE
c. PAID BY
8. DAYTIME TELEPHONE NUMBER &
10. PREVIOUS GOVERNMENT PAYMENTS/
9. TRAVEL ORDER NUMBER
AREA CODE
ADVANCES
11. ORGANIZATION AND STATION
13. DEPENDENTS' ADDRESS ON RECEIPT OF
12. DEPENDENT(S) (X and complete as applicable)
ORDERS (Include Zip Code)
ACCOMPANIED
UNACCOMPANIED
c. DATE OF BIRTH
a. NAME (Last, First, Middle Initial)
b. RELATIONSHIP
OR MARRIAGE
14. HAVE HOUSEHOLD GOODS BEEN SHIPPED?
(X one)
YES
NO (Explain in Remarks)
d. COMPUTATIONS
15. ITINERARY
c.
d.
b. PLACE
e.
f.
a. DATE
MEANS/
REASON
(Home, Office, Base, Activity, City and
LODGING
POC
MODE OF
FOR
State; City and Country, etc.)
COST
MILES
TRAVEL
STOP
DEP
ARR
DEP
ARR
DEP
ARR
DEP
ARR
DEP
ARR
DEP
e. SUMMARY OF PAYMENT
ARR
(1) Per Diem
DEP
(2) Actual Expense Allowance
ARR
(3) Mileage
(4) Dependent Travel
16. POC TRAVEL (X one)
OWN/OPERATE
PASSENGER
17. DURATION OF TDY TRAVEL
(5) DLA
18. REIMBURSABLE EXPENSES
12 HOURS OR LESS
a. DATE
b. NATURE OF EXPENSE
c. AMOUNT
d. ALLOWED
(6) Reimbursable Expenses
(7) Total
MORE THAN 12 HOURS
BUT 24 HOURS OR LESS
(8) Less Advance
(9) Amount Owed
MORE THAN 24 HOURS
(10) Amount Due
19. GOVERNMENT/DEDUCTIBLE MEALS
a. DATE
b. NO. OF MEALS
a. DATE
b. NO. OF MEALS
20.a. CLAIMANT SIGNATURE
b. DATE
c. SUPERVISOR SIGNATURE
d. DATE
21.a. APPROVING OFFICER SIGNATURE
b. DATE
22. ACCOUNTING CLASSIFICATION
23. COLLECTION DATA
26. TRAVEL ORDER
24. COMPUTED BY
25. AUDITED BY
27. RECEIVED (Payee Signature and Date or Check No.)
28. AMOUNT PAID
POSTED BY
PREVIOUS EDITIONS OF DD FORM 1351-2 AND 1351-1
DD FORM 1351-2, MAR 2000
Exception to SF 1012 approved by GSA/IRMS 12-91.
MAY BE USED UNTIL SUPPLY IS EXHAUSTED.
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