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i 1. DEPARTME R ESTABLISHMENT, BUREAU DI N OR OFFICE Department of Justice, FBI 2. TYPE OF ™e. ( +TEmMPORAR TY PERMANENT CHANGE OF STATION TRAVEL-VOUCHER (Read the Privacy Act Statement on the back} 5. |. NAME (Last, first, middle initial) b. SOCIAL SECURITY NO. a PISTEY, EDMUND J. ~ ° < ¢. MAILING ADDRESS (Include ZIP Code) d. OFFICE TELEPHONE NO. = WASHINGTON, D.C. 2, NUMBER(S) a! w z _ 271-62 & e. PRESENT DUTY STATION f. RESIDENCE (City and State) NEW ORLEANS NEW ORLEANS 40. CHECK NO. 8. TRAVEL ADVANCE 9. CASH PAYMENT RECEIPT 11. PAID BY a. Outstanding f a. DATE RECEIVED b. AMOUNT RECEIVED b. Amount to be applied | $s Cc. Amount due Government (Attached: Oo Check 0 Cash) ©. Balance outstanding c. PAYEE’S SIGNATURE - GOVERNMENT | hereby assign to the United States any right | may have against any parties in connection with reimbursable TRANS OR TAT 1ON transportation charges described below, purchased under cash payment procedures (FPMR 101-7) TRANSPORTATION 3. VOUCHER NO. 4. SCHEDULE NO. 6. PERIOD OF TRAVEL 1/1/84 1/31/84 7. TRAVEL AUTHORIZATION b. DATE(S) 6/1/62 b/E > Traveler's Initials TICKETS, IF PUR- . POINTS OF TRAVEL CHASED WITH CASH AGENT'S (List by number below| VALUATION DATE and attach passenger OF TICKET AND ACCOM- ISSUED FROM TO coupon, if cash is used (Initials) | MODATIONS show claim on reverse side.) fe) fa) PER CIEM ARE G 13. I certify that thi cher.is true and correct to the bést gf my knowledge and“bevef, and that payment or credit has not been received by Zivnth applicablg, per diem claimed/is based on ghgraverage cost of lodging incurred during the period covered by this voucher? . {] U TRAVELER gil A } TE gS AMOUNT SIGN HERE "Ae A Zeal 3 CLAIMED NOTE: Falsitication of an item in ap i 2514) and may result in a fine of not more than $10,000 .. imprisonfrent i.d. 1001). 14, This voucher is approved. Lontndisténce telephone calls, if any, are certified as necessary in the interest of the Government. (NOTE: If long distance telephone calls (f) | 1 s Le 17. FOR FINANCE OFFICE USE ONLY COMPUTATION ! are included, the approving official must have bee orized in writing by the $s ! head of the department or agency to so certify (37 U.S}C. 680a).) , APPROVING sy” DATE OFFICIAL i] DP Xi SIGN HERE . KY ar D 15. LAST PRECEDING VOUC AePAID UNDER SAME TRAVEL AUTHORIZATION ib. TOTAL VERIFIED CORREGT FOR - | 3. VOUCHER NO. b. D.0. SYMBOL ) ¢. MONTH & CHARGE TO APPROPRIAJION ~ I : Certifier’s initials: £5 5. THIS VOUCHER IS CERTIFIED CORRECT AND PROPER FOR PAYMENT lc. APPLIED TO TRAVEL Af (Appropriation symbol): VJ | AUTHORIZED . / $ CERTIFYING DATE OFFICIAL I SIGN HERE 18. ACCOUNTING CLASSIFICATION 1012116 : NSN 7540-00-634-4180 STANDARD FORM 1012 (REV. 10-77) Prescribed by GSA, FPMR (41 CFR) 101-7