Dd Form 1351-6 - Multiple Payments List
Download a blank fillable Dd Form 1351-6 - Multiple Payments List in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Dd Form 1351-6 - Multiple Payments List with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1MULTIPLE PAYMENTS LIST
Page
of
Pages
PRIVACY ACT STATEMENT
Title 5 USC 5516, 5517, 5520, and 5701; Title 37 USC 404-427; and E.O. 9397
AUTHORITY:
Used to supplement DD Form 1351-2, "Travel Voucher or Subvoucher," to substantiate claims for reimbursement when multiple individuals of an
PRINCIPAL PURPOSE(S):
organization are performing official travel at the same time, between the same points, and accounting data is the same. The information collected may also
be used as a payroll list.
Information may be furnished to an employee's state and/or local taxing authorities, to comply with agreements entered into by the Secretary of the
ROUTINE USE(S):
Treasury, for verification of filing information used by an individual in a tax return; in addition, release of information on this form may be made to Federal,
state, local or foreign law enforcement agencies, for investigation of and possible prosecution of an individual charged with violating any law, statute, rule,
regulation, or order in this claim for restitution.
Voluntary; however, failure to furnish requested information may result in total or partial denial of amount claimed.
DISCLOSURE:
D.O. VOUCHER NUMBER
1. TYPE OF PAYMENT (Check applicable)
MILITARY PAY (MP)
TRAVEL ALLOWANCE (TA)
OTHER (Specify)
PAID BY
2. PAYROLL NUMBER (If applicable)
3. DATE OF COMPUTED PAYMENT
4. ORGANIZATION AND STATION
5. PAYEE IDENTIFICATION
e. TRAVEL ORDER
g. SIGNATURE
OR OTHER
f. AMOUNT
OR CHECK NUMBER
AUTHORITY
a. LAST
b. FIRST
c. MI
d. SSN
1
1
2
2
3
3
4
4
5
5
6
6
7
7
8
8
9
9
10
10
11
11
12
12
13
13
14
14
15
15
16
16
17
17
18
18
19
19
20
20
21
21
22
22
23
23
24
24
0.00
PAGE TOTAL
6. ACCOUNTING CLASSIFICATION
7. PURSUANT TO AUTHORITY VESTED IN ME, I CERTIFY THESE STATEMENTS ARE CORRECT AND PROPER
a. NAME AND TITLE OF CERTIFYING OFFICER (Please type)
b. CERTIFYING OFFICER (Signature)
DD FORM 1351-6, JUN 93
Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6
Adobe Professional 7.0
Reset
(NOV 64), which may be used until DEC 31, 1993.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business