You are on page 1of 54
EPU_Exp_9.2.13_ 10.6.13 si “+ NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY = YX ay REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED FD , IN THE DISCHARGE OF OFFICIAL DUTY 3 3 INSTRUCTIONS TOCLAIANT. Submit one asia o Generel Accouning. Allah all necessary ona eclps and other supportng documents tots frm, Incuding any prior wren approval of excaes registration, aging, and out-of stalelcunty avo. Retain ane (3) copy for your ecard, Comglate amour, ‘company, account, and centr fells Fie atleast monthly end not lator than 30 day aac month ends. Prepare nk or ype, ‘Pav Via Poe Na waraaaeTi Re!mbursomont for approved training expensas must bo submitted to OSOT. Siena Fernie state Highwey Patrol Executive Protection Dotal Payee sens tee “le Coan tia & Fie 200 North Blount Steet Irrooper lnsiolgh, 1 (chy. os. 26) Pret tig Fe om eins Goat sain en IRlgiah, NC 27601-1008 acite 443109213 ‘One tele 2 pay nt is obe aor and ato aan os chy Tra arin bronzer es 9 0 alata tedgra operand seuncarurctnta wren th Sia. tae 1 spt, ne gon propor everigatave adorn of ptt erty at rae ae nse. vi (2 (Seven So) Bae) ZEKP0 0 /]2- 6702 [3 Seas 5 P camer 2006. 90a 008 300 Taal pea et Due (Ove) q SEP 14 ama and arrival in Fw) S08 % 7 "Travel show each ay vised) Traneporaton ‘Sibelstonce ‘Other Travel Expenses Day ‘tom e InStato [outst TrState [Ouratstal] Explanation | _ Amount aie isi Pris Coe omy avn corsage wai 2 oy Pisce i ost va car owas oo t 2 ‘e | Sia, iy Pinar ioe ‘Saenia sty Pvt Co Mi isa, ‘GRAND TOTALS $58.70 (2) Type of subesteca: Iwo: Daly total for subsistence no 0 Otver, al, bus, ton, parking fea. AwAk R= Rentloar Bar lo oxcsed athorznd amos fort hy sas OE Sofie oon crt tava a) oug0u N39 Ni G38 fay of dered cor snore ces set ORCC rome, in eed Free 8 Nap apron rnin 1 NORTH CAROLINA DEPARTMENT oF PuaLic SAFETY =) WWW SLO REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY INSTRUCTIONS TOCLAIMANT, Submit one olgal fo General Accounting, Allach a necessary ginal recep and other supporting documents ths form, MResng any prior writen approval f exces regis, lodging, end ou-o-stttcouriy travel, lan one (1) cap for your records, Completa amount Company, eocount ard corer les, Flea east ronthy and net ler then 30 days ater month ends. Prepare kc ype. STR GSES FTITTHTT ——]Renburserent for approve tanng expenses must be submited to O80. San iia reset ‘f-f=|=}=/o}-|=]21=|o|-[+|2} 1 Yupl 42, Sale # 7420288 yrs Go ao 7 - Diy Pet tarps iy Brae or UNLIMITED HASH” 5 ste terting at only $30 @ wth! Ser re Grog attendant for dotatis — [rte ar ag [se Frnt ox loge Fate aap Tanke oxy rane cor oape canst ay ina aape Santee [oa ica tong acme ‘GRAND TOTALS | =|0|-{2] 2} /-l=|2]=/>1-(ol2 | <\o|-l2lz|/o|-|al orm CNTR 009 Relmbureerent of Travel and Cher Expenses Incured nthe Discharge of Oftal Duly Fon structure lest revised February 2013 NC Desestment of Puble Safely, son of Administration y NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY RECE ! VE D REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED Ot? 3 § RECD IN THE DISCHARGE OF OFFICIAL DUTY HUB) INSTRUCTIONS TO CLAIMANT. Submit one eign] to General Accounting. Atach all necessary gal resipis and other supporting documents thief, Including any prior wren approvel of excess regsiraton, lodging, and ou-f-talelcounty travel, Retain oe (1) copy for your records. Complete amount, ‘company, account, and center ek. Fea lest mony and not later than 30 days afte month encs. Prepare inn op. Pape Wk Poe oa TOTS aa |Retmbursemartfor approved training expenses must be submiteg to OSDT. aya a i aah ay Tranactan Fecal ING Stato Highway Patrol Exocutive Protection ayes Arn (Se “te Gest Nana Bower 200 North Blount Street ‘State Trooper leigh, S-1 erat rong te amo aes Coasts Rain! Wee} (Ralaiah. NC.27601-1008 aT. losi7/2019-c0/0872019. spn psp cart Se an aetna a 7 Tha amid in vavenet meuel ocr Pa iat an are cll. expane an overs cure be arden be Ste | free Hele, Thre er arent owen tae andre parse ry at wa be ser on ofr asco Bear rane, vote 13-13 Gp272 wor (Senet Sie) ‘any malin 809-773-327 Ep oto 113-9 01 Ber me ae : = eet oe rt ss i Hara 4 = He pee 1 We raomom [WEE 40] p oct 3-203 37 MB 9-963013 Ee a ae Se TESS Day ‘tom © inSiae [OwerSie irrstawe [ouotsine| Explanation | _Ancunt aS 2 | aa, 2 6.10 Er Crepe x fas = ‘i 5 iy rl ara me ly rt Cor Manage rs oo va [any ne cortege peur ‘GRAND TOTALS $6640 P= Privala car O-= Other, ral, bus, tax, parking fees A= Ale i Bal be jio excead aulhorized amount for In- = Fo1m CNTR 003 Relmbursement of Travel nd Othor Expenses cured in the Discharge of Of Dy Foim structure lst revised February 2013 NC Department of Poble Safely, isin of Administration Travel (Show each oy vised) "Taneporaton ‘Subsbtonce ‘ther Travel Expenses tom © insiate [oats TrSinie [OwotSinie| Explanation | _ Amount "TOTALS BROUGHT FORWARD Jo F a0 Prete era te Car Powis Pole Cores iy rat ar Wap sy it oe ag yee ap Tea [Sy Pris Cae memreno Beet [rte ar age ost hoi ar ae Bly ho a Ne ey Psa CaM ai rv ar ase fat Pn Car eas diy av wae ost Pie Cx ewe: el felet=|ol-|=|a=|2l-l=|=}=fol-lo]=1=|o-Joz}=lo}-|=/z)<{o\-faef|-lf|=|o]-|=|2]=lo]-l2]3| Form CNTR 003 Relmburcemont of Travel and Other Expenses Incurd into Discharge of Oficial Duly Form siuciae last revised Februty 2013 [NC Doperiment of Puble Safety, sion of Administration REWEIViLs NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY sey 28 REED REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED *" IN THE DISCHARGE OF OFFICIAL DUTY \Y INSTRUCTIONS TO CLAIMANT. Submit one eign to Geraral Accounting, Altech a necessary aigha rcspls and othe supporting documents tots form, Incudhg any prot wlan aperovalo excess registration, ldghg, and out stallcounty travel. Retain one (1) eopy fe your records. Complate srnount ‘company, aacount and oantorfebs, Feat eze ony and not later than 20 days ator ron ends. Prapere ako ype. Para Wek Pie ae TIOTITTETT ——]Roimbureement for approved traning expanses must be submitted to OSDT. = Ta reer z [state Highway Patrol Executive Protection Dota Der nore "We ezine RT 200 North lount Steet lester Trooper leigh, 84 {Gly 5,20) Pra Weng ar acto asd Gaoeetay Roar i zt lr zoss. e203 ‘trusts poy fsb ww we oe a Tey Tia sarod freeones rca tal isd sso ttisgra expenses ed etwrca rxredlie ente Sm IRae Yost thar gen tr proto og dere ol peeond ery al colt inked tom an a swe Pae fare open vee SESS ‘Conan Sra) aos) Be Za? 3-04/a}> ; 0003 000 oot. oy 0008. O06. 0007 008; 00 “Te 018(099) tecord the act “Travel show each ay valled) "Transporation Day ‘rom ‘e in-state [ower Sue 2 | In-State [outsestae| Explanation [Amount wma z cepa r ory aa iy Prt x Mane iy ev a weno TET B20. 0. si rie Gage st re cox age coo rn r ‘GRAND TOTALS $97.30 (1) Mode of rave: {2) Type of sbsitence |noTE: ty ital or subsistence no vale car O= Or, a bs. paring foes AA R=ROWHT [JY STH Ei fgeroe aupafind pra Dinner ‘Goan Et Form CNTR 009 Reimbursement of Tavel and Other Expentes Incured Inthe Discharge of Of! Duy Foim structure last roveed February 2013 NC Department of Puc Safely, DNsion of Administration 1 "Travel (shaw exch ely vised) Traneporaton ‘Subetstonce ‘tom © Tnsiate [ours] insite | Outed Sate TOTALS BROUGHT FORWARO Bo eee $87.30 sy Fri are iy rote Ceci fee Gs vers ea ag ay i ar eae Sa i a a se [a Pi are tyr ca oe iy rs or ae i ive Co i iy Fs Gs Mae sl Fa Ca Nice ssi vei cara er coins: % ee [anova carta re [an ate ce ain cer sy Ports oes ‘Sear ost Prt ae cee ony aaa Semaine ay Pa Ga Nees cone (GRAND TOTALS =| =|0|-|>|z | =|>|-|=|s =|>|-|=]2]=|o|-fo3 [2|o]~|=[z}=/>}-/2]2 1 =|o/-/2]z}<(ol-lolz| 1S INSTRUCTIONS TO CLAIMANT. Submit ene oranal fo General Accounting. Atach al necassary crghalrecelps and wher supporting documents to this form, Inciuding ay prior wren approval of excossreglstaton,fodlng, and cutoFstalofcounty travel, Rell ano (1) coy fer your recoes. Complete ernoun, ‘eompany, accoun, and contr fl, Fil at east monthly and nat later than 90 days flor month ends. Proper in rk x (ype. pes) NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Evecu, oe deck Fajen Wank Pe BETS |Reimbursoment for approved traning expanses must bo submited to ODT. 7 ea od ‘Biinectin [state Highway Palrol/ Executive Protection Detal res (Sot) te Toasn Mars & Tae 1200 North Blount Stroot Ireaopor IRaloigh, St 1,60, Zp) ere va Haas omer st onary ia Roa ea Raleigh, NC 27801-1006 (nie pros ot poy sy sob Wn en oars atc ay Ths rid seemed waa or ocpha empanes mdatoueeasraoresite sen ha i hr "epee, Tare inp appa i surg Yen lpr iy hat pat bret ey ot ca hae sam ere vate aie Lip l2 a 9. te Be ' ek re iam i EX, nt Wo. osu ot 0001 0902 ‘008, 008 00 6008. 0007, ‘08 000 ts Advence 5 icon act 15 2013 PROLO amc \o4yaos ecard the seal ne of denature and ariva i blocks indated “Transportation InSlate [Ouro F/5 PPR. FIV ani so 29-5: 09A313 -0 Yah? secon Travel (ohow each cy vistod) ‘rom © Subsistonce ‘ner Travel Expenses ‘state [owsrsiae| Explanation Day 7 iy ts ea ceca ‘Bap Carnage ‘Amount 3io.70 18.40 520 ‘aly Prime Gr tage Dat as Garage Tie ay erage Sa Pat cares Garant ct 2 = o o ‘GRAND TOTALS ‘$6030 1) Mode of Travel serge entre (MOTE Daly tl subsist na P= Prvale car O= Other, albus, tox, parking oes A= Ar R=Rentatoar — (]B-ePadeapt 01) Cie if exceed authorized amounl fore LeLinch = Houeing fsa or out-of stato Wave, ONDE gH Form CNTR 003 Reimbursement of Travel and Other Expenses incurred inthe Dlschargeof Offi Duty Form etructure iat reveod Februsry 2013 [NC Department of Pubic Safely, DMsin of Administration 1 NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Gousnors Roeedin <2 ° REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY INSTRUCTIONS TO CLAIMANT. Submit one oighsl to General Accounting. Allah all necessary oigha ecxpts and other supporting documents to hs foam, Incuding any prior wien approval of excess epson, lading, and ou-oFstatecounty travel, Relah one (1) copy for your records. Complete amount, coenpany, account, end conor Nels, Fle atleast monthy ena not eter than 30 days alr month ands. Prepac in nk oF type JRelmbureoment for approved training oxponses must be submited to OSDT. Paya io Pome Kamae OTT ea aa Braman Faas Stato Highway Patrol Exocutive Protection Dell Payers pase (Sa) "Te Tsien tone Sani 200 North Blount Stroot Irreopor IRaoigh, 81 (ety, SZ) al ey as om aia Comray ia eae roo lealeiah. Wo 27601-1008 sraots-ot6/2019 Thao and Pe iam ca ation nono ‘hae pra 3 psu coy Tino be ata ae aca siamet aio iin erprae an eared vant St art {rope na anes ae vel ee eters abe ay oe aera sa epee. eta, a Lizle a P22T =a ay Ws- 777387) ory aan aa [F]F~6 4/63 oO ‘02, ‘008, 0c 008. 0006. 007. 08 ‘D008, "ial ape “a, Ou (Ov) 8 JOH 201% jecord the actual time of Ln blocks Indic Subettonce ‘Other Travel Expenses Travel ehow each ty vila) Tronaporation inStato [owetsite] Explanation | Amount tron © Triato [ourarciae| rs an [iy Pr aa Cu EO} yr Cx ate [sy Pincers Sete foyer ee ‘GRAND TOTALS 730 ) Mods of Travet: 2) ype ct eubsistence: |NoTE: Daly toa for subsistence nol te exceed autnoraed amour for in PoPhme O-Ome. cna inipunnaber AAV DIRE OETA osaee Maneater brome" ei OLoGV NO Wi C.Oay 2 2 Form CNTR 009 Reimbursement of Trove end Ofer ExpansesIncued inthe Discharge of Offa Oty Fotm tuoi fat roveod February 2013 NC Department of Pubic Safety, Dision of Ariston 1 REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY mal 29 INSTRUCTIONS TO CLAIMANT. Submit one orginal fo General Accounting. Atach al necessery oie! receipts and other supporting documents to this ar, Including any pit ween approval of exoeee reptaion, edging, and out statelcounty Wavel.Felao one (1 copy for your records. Complete amour, ‘company, accoint, and conler feds, Fle atleast mony and nt later than 30 days tir month ends, Prepare in bk or ype. Bes) NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY (J... oyo.5 SD \ ar RR TOTET eimburseront for aproved taining expanses musth submited o OSDT. Ta na ey Stas Highway Patol Executive Protection Det ts ae 7a ome tara TR 200 North Blount Set eraoant asi, 1 ou, fon eas OE Fa Se lazeoararaots Tae an oe i Tha Hann TY Ta alae endo ba ROT Clete printers, ea Tapa. ane ps gata ata er eps on rend ton ccc ont a = AS Et po bags 3faqs wou coun scoouwt comer ® aps [2 * [5-12 2 ais [2 ‘008 ° lef . [ela ‘on ® is [a1 ‘07 3 ane 7 [s|2 0908 s a 048 ne} - wa 104-2013 ks indicat 46 203 1 Taal hon oon oat in ‘Sastre Oe Teel Bip insta [ones a Ean a = 3070 met Ha eae east barca erecoie Bai Prone Gor ase ee by Piva Cringe ee TE ‘GRAND TOTALS $7460 ct) Mods of Travet (2) Type of subsistence: foe: Dey cal for subeetence nl P= Private car ©'= Otho, all, bus, tax parking fees Aw Ar R= Rental car B= Broskfast to exceed euhorzed amount for OT 27 Reg, 195 Cape fe erutraae et OLOOW N39 NI G.O3Y Foi CNTR 009 Relmbursement of Travel and Other Expenses Incured inthe Discharge of Offa! Duty For structure lat rovced Febuary 2018 : NO Deparimeat of Pubic Safely, Dsion of Adinsvalion 1 NORTH CAROLINA DEPARTMENT OF PUBLIC weer ” REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED MANS 3 IN THE DISCHARGE OF OFFICIAL DUTY REDE Visit) INSTRUCTIONS TO CLAIMANT. Submit oe ciginal to General Accounting. Allah all necessary orginal recetps and oer supporthg ‘RECEIVE including any pir writen approval of excess rgistralion ladcing, and out--taalcounty revel, Relah one (1 copy for your records, Co ‘company, account, and enter els. Feat least monthly ang not lta than 30 days alr month ends. Prepare rk or ps. RaW RRC GETETHTT——Jrenbureoment or approved ning expences mat be sumitostoosor, Ly v 3 REC Sa = = : 2 — aie eS sada leat iy Thave carina Ta ralnboaboer eis en ee hs pra onscaa, Pe veree ol Sse. ihar “Tepper sparen rergh tl atl ie praca ldilie ‘Unerpnmies of pey Ieaiy bw ode gens elise har erat are en ay bes ers pre savas Toany DBE-B3Y Sf 0927/8 -0930)3 ‘01 0002. ‘00s ‘008 0a ‘008. ‘007 ‘0 C008, Taleo Te. 220 (One) vou, conpaser Other Travel Expenses ‘Expanation "Travel (ow each ely vsked) trom © Transportion insiae [Ouar so] Insite [oororsta| ‘Amount Day SEES a0) 1840) Se a we ay ra ar ape WaT Sse Pri or toape Cana (@ rian ‘GRAND TOTALS I) mode of Trove: (2) Typo of subitanoo: PrPhraecer On Cherm. x.pakratne AAT Re ROBT Ld BEAM Cy 0 = Dinner (oom) ‘$103.70 |wOTE: Dai total or subsistence nol lic excaed authorized amount oi stata or outof-siate ave Form CNTR 003 Reimbursomont of Travel and Other Expansas incced Inthe Discharge of Otel Duty Foim siraclue ast revised February 2019 NC Department of Pubic Sefty, Clvison of Admistraton ‘Travel (how each ey vied} ‘rom © "TOTALS BROUGHT FORWARD Transportation ineStote [Ovro-sne "bay 1 Tee re wiaz01s Dosa ny Pui ye Ga ae | Bie sy Pia cortege [ria Cone Pal Car Mle iy Er aro [sy Pi age a [any Pai ar tne ‘ene iy i ea a [oti Cor naoans Emon yar or Dai Pa woe [iy Pate Gre hae. i Pet ar cae fs ri Cane fy fei or os sy Pee cor age ‘GRAND TOTALS He =|0|r ale] =|0}-|o2]=|>]-|>)z}=|0|-/e|2}=|-\-|=|=|2[o]-l2]2) REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURR ee IN THE DISCHARGE OF OFFICIAL DUTY oct Y IN i INSTRUCTIONS TO CLAIMANT. Submit one cighal to General Accounting. Atlach all necessary orga! recaps and other suppertng documanis to this frm, Inotaing any por writen approval of excess regsralon ging, and ou-ot-stalefcounty revel Rete one (1) copy fr your records. Complete amount, company, account, and contr fete. Flo atest monthly ang net later than 30 days eter moni ends. Prepare n ink oye. Paved Woe Pow Rarbar TOT |Relmbursoment for approved traning expenses must bo submited to OSDT. i ‘hikaibeton pI State Highway Patrol / Executive Protoction Detall Payers ces (Sea) “ie ‘posion es canbe 1200 N. Blount Street Master Trooper [Raleigh 1 (Gy. 6o Zp) Joel Weng we ep ered Gomes 5s Roan! st} reer 102-2018/ 104.2019 ‘Jn pao pay [aly ita bros ad acne cy Tvs aaa ha ranaceower quo aed ye jad aware ‘ogra sepanse ar lowes Woues ie rete S. har Veo, hae gna opel avrg se wel pean! ay al nat nbn Fm ya rosea lar se onsets, ato A 3 /3 oO ‘001 oaz 0005. 000 008 0006. ‘0007, ‘ne ‘000 Taal apes et 0009) OCT 45 2013 \04-D03 “Travel (show each aly veled) "Taneperaton ‘Subsistence ‘Other Travel Expenses ‘rom 0 InSite [Outer Sia TrState Towotsiae | Explenation [Amount blocks inl Ta 7 Dan rie conics ay Pi aap Sena nly Pra Cova ee (GRAND TOTALS $26.60 aad trem ard eigesrgentmes oro ar asa cbmc 0 Cher rN as pathgfon AZAR Re 4s ‘e ee crtnohed ome a SORET Uf PERO OU, vaungfttecr outa tvs or oA a3 Form CNTR 008 Reimbursement of Travel and Otbr Expenses Inoured In Bs Discharge of Oil Duty Form siructre last revised February 2019. NG Deperimant of Puke Safty, Divison of Adminstration 1

You might also like