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FD-794 FEDERAL BUREAU OF INVESTIGATION Version 2.0 Revised 02/04/2020 PAYMENT REOUEST to usc appropriated funds for conduct of its authorized activitics). Your Social Sccurity Number is solicited as authorized by E.O. 9397 (Nov. 30, 1943), as amended by F.O.13478 (Nov. 18, 2008). Thc information sought will bc used by the FBI to process your request for an advancc payment of funds or requcst for reimburscment for authorizcd commcrcial or sourcc-relatcd cxpcnscs.Disclosurc of the requcstcd information is mandatoryfailurc to provide thc requcstcd information will dclay thc processing of your requcst and may result in its denial. This information is maintaincd in thc FBI Central Records System, Justicc/FBI-002, a description of which can be found at w:go.thinti0/X/.TB/Clu/rivayCavi%20lbetis%20irwy/oxs/l002.asx.This information may be disclosed in accordance with the routinc uses refcrenced in this noticc.. Cost Cade*: Forfeiture or Drug Related*?. Yes No b6 -1 b7C -1 Program/Subprogram (if not listed, type the 4-5 digital code): 4-5 Digit Code*: b7E -1,2,3,5 Neexhep tse the a ooi onre o cogrmcorree Prspby cuse casseaion INFORMATION ABOUT THE REQUESTING EMPLOYEE Official Burcau Namc:(Iast,First, Middlc Initial) UEID: Datc of Rcquest: Division: Scction/RA: Unit/Squad: Telephone Number: (include area code). Case Number*: Was/will the cxpcnsc bc paid by an altcrnate employee? YcsNo Is this a one time non-symbol source payment*? YesNo If an expense was already incurred, was it paid with personal funds? If yes, please select your preferred method of reimbursement: Yes No Personal Bank Account (EFT Justification*: To be completed by FINANCE OFFICE ONLY Organization Fund: Program: Sub Program: SOC: Sub SOC: Description*: Amount*: Level 2: Total Request: Add Ncw Row Remove Row To be completed by FINANCE OFFICE ONLY. BBFY: EBFY: Project: User Dimension 4: User Dimension 5: FD-794 Page 1 of 2 FEDERAL BUREAU OF INVESTIGA?(ERI)-9509