ࡱ> XZRoot EntryRoot Entry` )HcYContents[bOccDataSummaryInformation(   !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVW\]^_`abcdefghijklmnopqrstuvwxyz{|}~FBMacrosqccGeneralMacroStream( 907-`!Oh+'0ݤ   ( 4 @LT\ȤФMultiple Payments List whs/dior WHS/DIOR47@/@ 8@@0cGP48DO Q,#  "2 -%000000- -%00S0SP0P00-.- "Univers !w*wgw -"Univers V!w*wgw V -- (2 DMULTIPLE PAYMENTS LIST     "System  - -0S0PSP0SQS-.- "Univers !w*wgw -"Univers W!w*wgw W --  2 C]Page- -00PP- -00PP-.- "Univers !w*wgw -"Univers X!w*wgw X --  2 Cof- -00PP- -000QPP-.- "Univers !w*wgw -"Univers Y!w*wgw Y -- 2 CPages--.- "Univers !w*wgw -- '2 ZfPRIVACY ACT STATEMENTT---.- "Univers Z!w*wgw Z -- 2 g> AUTHORITY:"Univers !w*wgw - "Univers [!w*wgw [ - - '2 z>PRINCIPAL PURPOSE(S):"Univers !w*wgw - "Univers \!w*wgw \ - "Univers !w*wgw - "Univers ]!w*wgw ] -- 2 >ROUTINE USE(S):S"Univers !w*wgw -"Univers ^!w*wgw ^ -"Univers !w*wgw -"Univers _!w*wgw _ -"Univers !w*wgw -- 2 > DISCLOSURE:--.- "Univers `!w*wgw ` -- x2 fKTitle 5 USC 5516, 5517, 5520, and 5701; Title 37 USC 404-427; and E.O. 9397"Univers !w*wgw -"Univers a!w*wgw a -- 2 xUsed to supplement DD Form 1351-2, "Travel Voucher or Subvoucher," to substantiate claims for reimbursement when multiple individuals of an"Univers !w*wgw -- 2 organization are performing official travel at the same time, between the same points, and accounting data is the same. The information collected may"Univers b!w*wgw b -- 62 also be used as a payroll list."Univers !w*wgw -"Univers c!w*wgw c -- 2 Information may be furnished to an employee's state and/or local taxing authorities, to comply with agreements entered into by the Secretary of them"Univers !w*wgw -- 2 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,"Univers d!w*wgw d -- 2 state, local or foreign law enforcement agencies, for investigation of and possible prosecution of an individual charged with violating any law, statute,e"Univers !w*wgw -- ]2 9rule, regulation, or order in this claim for restitution."Univers e!w*wgw e -"Univers !w*wgw -- 2 uVoluntary; however, failure to furnish requested information may result in total or partial denial of amount claimed.- -%0pp00-.- "Univers f!w*wgw f -- %2 51. TYPE OF PAYMENT  "Univers !w*wgw -- "2 (Check applicable)- -%0MM00-.- .-    - $9D9D-  9DD9 -- -  --  -%MMM-.- "Univers h!w*wgw h -- !2 RMILITARY PAY (MP))  - -%-.- .-    - $-!! -- -  --  -%vv-.- "Univers !w*wgw -- '2 TRAVEL ALLOWANCE (TA) - -%vvv-.- .-    - $-!! -- -  --  -%pp-.- "Univers j!w*wgw j -- 2 OTHER -!#@ J (@  "Univers !w*wgw -"- 2  (Specify) W-" -%ppp-.- "Univers k!w*wgw k -"- $2 uD.O. VOUCHER NUMBER "Univers !w*wgw -#-# -%0 0 0-.- "Univers l!w*wgw l -#- $2 52. PAYROLL NUMBER  "Univers !w*wgw -$- 2 (If applicable)B-$ -%pp  -.- "Univers m!w*wgw m -$- 12 3. DATE OF COMPUTED PAYMENT  "Univers !w*wgw -%-% - 0 q p1p 010-.- "Univers !w*wgw -%- 12 )54. ORGANIZATION AND STATION-% -0ppCq- -ppp-.- "Univers o!w*wgw o -%- 2 PAID BY-% -ppp- -000-.- "Univers p!w*wgw p -%- +2 55. 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PURSUANT TO AUTHORITY VESTED IN ME, I CERTIFY THESE STATEMENTS ARE CORRECT AND PROPER  -( -000-.- "Univers !w*wgw -(- C2 5(a. NAME AND TITLE OF CERTIFYING OFFICER "Univers !w*wgw  -)- 2   (Please type)-) -%-.- "Univers !w*wgw -)- *2 b. CERTIFYING OFFICER N"Univers !w*wgw -*- 2 , (Signature)p-* -C--.- "Univers !w*wgw  -*- 02 5DD FORM 1351-6, JUN 93 (EG)F      -*-.- "Univers !w*wgw -*- `2 ;Replaces DD Forms 115 (MAY 74), 1351-1 (SEP 61), and 1351-6Z"Univers !w*wgw -+- N2 0/(NOV 64), which may be used until DEC 31, 1993.-+-.- "Univers !w*wgw -+- I2 J,Designed using Perform Pro, WHS/DIOR, Jun 94-+WWOWWOWWOWWOWWOWWOWWOWWOWWOWWOW FormFlowFormFlow 2.0566 PAGElt@. PAGESt@. MILPAY@ hB!hB JBJB K~B~BPress the space bar to enter an X in this box and/or tab to the next box. `B`B TRAVALLOW@ B"B —B—B OTHERPAY@ B$B BB ORGSTAT @. PAIDBY @. LASTNME @. ʪB ʪB 1BBEnter last name ONLY and tab to the next field.FIRSTNME @. ЬB ЬB BBEnter first name ONLY.MIault @.  SSNult @. B BBBBB-- /֮B֮BEnter numbers only. 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