se} NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY ALLL SES” TNSTRUCTONS TO CIANANT “Sur ane tga Gee Azouring Alachelneasay Tara eno oh" wiping doers fis om edgy po Sram apport ofece epaiion apra onautt seman toe. Ren oa) ay ace onda eat ‘torrent imetnon 38 cy ma ede Pryor ae Payeee wi Phone number GHOTSSSET! 7] _Reimmarsemertfer aprovestraing expenses muse submited tv SOT. | [sie Wa, Last [Division/Section 7 S _ FZ ieee Dyess ar eastsree rie PO cx rarer soon runt Tice Rategn si _ ji. Sate 1 [Roars Wotig Hors onto Pron covered by ms Regie omic) Ratan NG 77601 lsep tnaore vane pensar Twaphone 8 3G Got 000 3009, ‘oo TE ea == Eo peat d /, Ogle RECEIVED eR | Epa = $0.00 TRANSPORTATION Ou-OFSiaie ro Dai Piva Dat Pv Tas Degart Daly Prvate Car Reape [Daiy Private Co Nieaae Day Prvate Car theage (Day Private Car Menge 030 Tm S75 GRAND TOTALS 5 Tatar [eas Toe Bip By Type of Subieancs State 1 toe of Tevet: Brokat ‘820 P-Prvale Car” O Otter sal bus. ta sahing fees A= Ar R= Rental Car S108 $1870 |uore: omiytt ersunee $8730 frotioercerd eunoraes amour | ican 6 Foun CNTR 003 Reimeursement of Travel and Other Expenses Incurred inthe Discharge of Oficial Dury Foe Struc ast evised July 2015 NC Department of Puble Safety, Dvion cf Adminstration‘Dhar Tavel pers Exploration —| Aro ‘SUBSISTENCE T Sie | on0rSiae nso] 7 20 TRANSPORTATION Testa [outa Sie TRAVEL (sfisw each Sly we) Ba Fen Ts [TOTALS BROUGHT FORWARD. ae Depa aie ly Pate Cae ay Prva (sre. —— Depart] [Daiy Private Car eager w [Gay Prvate Ca Depa Arie Daly Beate Car aage, [Bass Private Car age z @ oars i Mesos TH [Dany Pavete Cartas “om O56 [Daly Prvale Car Mssoe are bes e ‘rns Daly Pree Car nieages > 050] Sety Pavol Car tee oge e057 Ts Depart} Daiy Pree Ca Mieage ‘Baiy Private Ci Dy Private Carwhwage (Say Private oo a 3 > o ‘Arve (ay Private Car eage Eom [Ga Povate Ca 0575 imi Tae Depa avs Dai Prva Car Wieage @ 00m ‘Daly Private Cor Mieage Te Depa Five Cae i Trai. Depart (Daly Prvate Carag ‘Daly Privale Cas Mileage leet > > z = é 6. Depart tL (Day Prana CaP RAR e030 ml x Tear [baey Pavave Car iesoe @ 0575 mi il 15 Total 23) TRANG TOTALS fas Tom ice Be Form CNTR 003 Reimbursement of Travel and Other Expenses incited inthe Discharge of Ofcial Oy om Stet at ree iy 2015 2 INC Department ef Pubic Safely, Dvsion of Adrnistation erryNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED — = IN THE DISCHARGE OF OFFICIAL DUTY 1430S INSTRUCTIONS TO GIAMIANT Sint one crgralio Gara Aoroonng. Atcha cea orga eons ar afer supsonng canines is forn weaina wy wer tron sprealo excese regan, gg ne cutee wave. Reta oe) 9) yn eons Compe acu amp, acum apd c2nar Tas Flat lees hy afc Nat ater Wan 3 days ate moh exds. Presa Ws 2 ¥52 [Payee Work Phone Number —__(oT9/759.3871 Reimbursement for approved raining expenses must be submited to O80. ry Jota, Las) fBweerrsecnon ce Law Enforcement Dwision Stale Highway Patrol EPO rite i Rmber lzcon ae. Trooper aalegn si [ctr Sate, 2) [Navmal Woing Were thervoy Period Covered by ts Ragen oro) ih NGZ7S04 statip ksr72016- 9113/2076, rt ao pony OA RAT Hn TEI RTT inare eno aprove Dem rattan! pes he ig enenandaimaren scarce tte ame ctoe Sum ua oy 216 FSipersor Tepe 9) 007 002 ‘Oo ‘and 00s ‘anne 20 Tata expense Tet. Due (Ome) ow. sally Record the actual time of deperture and ativan block indi eal Ash Commisshn Stpers (aren ee Tea Taaioa oat : - — eae 7 tat sat it i — fies CS comsnwinRECEIVED mcs | fis fem JUN 3 f 26 auumennene esas! D-Dimer 32130 Form CNTR 008 Reimbureament of Travel and Cther ExpencasIncred inthe Otcharge of Offa Duty Form Structure last ewsed July 2015 [NC Depatiman: of Putee Safety, Division of Adminisaon“TRANSPORTATION ‘SUBSISTENCE: ‘ier Tel Exposes Tr-Stale | -Om-orSate 7] eS | Our Sate ination | Amour [eo "TRAVEL ehow each ely vied) Fron a ra ras Car [Day Prva Car ee iy Prvale Car Bag aly Prvale Car tiloage lS I-felS}=lolleI By ay Private Cae aly Piva Car Mea i [Bai Prive Car Moape [ay Private CarMieage Depart tie [bay Private Cary Pavate Cor erie [bay Private Carta [Day Private Carter Depa ae Daily Private Caray Daly Brae Car tay ee iy Private Car Moa Bouse Car Mag Depa ‘Ave iy Prvaie Car tibage aly Private Car ve De Arve iy Pavate Car Meage vate Car Wi Dea Arie Private Car age iy Private Co teage eae eve Peat CaP TBR ovate Car Mieage 3 Tl t a 1 2 2 o t 2 rr i Form CNTR 003 Reimburseret of Travel and Other Expenses Inced inthe Discharge of Offi Duty Form Structure lal revised July 2015 [NO Deparment of Pubic Sale, Diision of Administration¥qS47 E1576 woptn caRouNa DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Lay wales vs a oer supbang aoc is, ese, te Comte arcu. compar cov. on cee Fl Fle at ‘brat oe gral o Gere Acaurng. oral pexassay gral tien poral et eseas egitaton, nig and oi taco aut fan oe) coy you [Est morniy ng ot ater than 30 aye ae on ers. Prepare ko oe f Reimbursownt for approved ain expansee must b submits to OS) [Payess Work Prone Nuribor (@Tay7a3-3871 iia La) “|ovasionseeton [Low Enforcement Division / State Highway Patrol EP ae Ts = Recavon ame Hamer 200 Beunt st “reaper Raion Si cay, State. Zp Noemal Wottng Hours (Fam) [Peiod Covered by ts Rogues Reno sta-ttp 8072016 8/91/2018 Raleigh. No-27601, Ta sane a titers estab oy Rl AT STaRTSSE F o-7-fé LB AS IST sat Teeprone 3) vacate Sue ay — oa [ avoir) | cow | acco Sie z a ToT t T wa re I ete 7a ne > statatrpets [see 7 trate + Er ‘a00s Ts z 5f3 q ‘a 0007 onte ‘0 a Toi exces [$a a . So Tot Due Owe) (Ewe) ie a] Ve ‘Record the actual ime of departure and ativan blocs indicated, «fel Coa Ash Commission Stipend Daye J x15 $0.00 TRANSPORTATION, SUBSSTENCE ‘Gina Tavel Experi Toisas | OW oT State | OutOrSiae |—Eplanaion | Aria z 7 330 z T0307 o —|— es eo | P —FoH Fa iS Teal z 230 a i — [Baty vale Car Mies 030 ml — — [Tear [Daly Private Car Micage. 0575 mile 3H Ts. Tota Depa x = — [Day Prva Car mane Sow male 7 lata [Dee Private Cac Mieage 2575 ml ay 5 Tatar Grab ToTALS 7 —T ass Torr ae Ep (2 Type of Subsistence: nate yaad of rave 8 Break a0 PPro = omer rnb. a, ann Azar tunes i099 Cer 870 aly alr tet Hews Ron) $67.3 ceed auorued aut Brewin 5830 One $2130 Housing (aomy _§ 7980 Frm CNTR 003 Reimbursement of Travel and Ober ExpencesIncced in he Oscharge of Offa Duy Fou Strate last evised July 2015 NC Deparment ot Pie Safety. Dhsion of AdministrationRAVE (Grow onc wT TRANSPORTATION SUBSISTENCE ‘Cie Travel pense —) Fem, To T[ insite [ On OrSiae [2] —insige [Ost OST jonaton [Amount 3 TOTALS BROUGHT FORWARD % Depa are [Say Private Cara [Day Private car mle Pre Car GE T30TA Private Cor Weage T57n a 3. oy > Depa i Prvale Ca aeage @_030_imi iy Peale Cr Biba 575 mi Private Cor eage: | iy Private Car Mleage Depa ‘aes | [paige Coratey ay Pate Car No Ate ay Private Ca a al Pivale Car ay Private Cara THT ay Preval Cari 0575 i F BSSS SEES ESCROEOECLBSSE ‘ate iy Private Car Private Car Me [Dy Private Ca Daily Private Car Mi Depaa ‘ave [Day Private Car teege Daly Private Car tubeace Daa ‘re [Day Private Car he Tl [Dany Prvate Car Me 0575 imi Bate [Daly Prats Car Wana 3307 [eter [5 Toma [Daly Prvete Car Mie 575 im GRAND TOTALS ae fa8s Toad IS Ey 3. z 3. 7 = o e e z 3 z A ¢ Form CNTR 003 Reimoursement of Travel and Cther Expenses Inced inthe Discharge of Of Duy Frm Sruciue lst ewsed Jy 2015, INC Deparman of Pte Salty, Dvsion of Administration cccNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY l41useS— TNSTRUGTIONS TO CLANANT” Submilone ergnelio GeverlAccoming_Aaoval recesar aighalecapls wn ober sippoirg documanis Tie om, neue ary BE writen apzrovelofexcea eatin leg. o ot titeeaun'y vel. Reton one (confor yu teres Corpate ameun eompéry, account arc cer feds Fle a “Santmort ar not tr han 30 days taro ae Presta mek or (s10y7333871 Reimbureement for approved taining expenses must be submited to 0807, % [Dvasan'Secton = [Lew enforcement Division State Highway Patrol EPO Tie ‘ENrber DN. Bun! St “Trooper Fgh 5 iy, Stale Zo) Nema Working Pours trem) [Period Covered by te aquest (rom) Rategh NC27601 ate 1222916 4/26/2016 appa oven tvel a ef pean oc 42206 LB PIF S GPF ‘Siensnr Telephone 6 peat Cet eT Cj SEE tert ote SEF 0006, : t i - 0007 5 PAtID 008 { [ TT oa Oia 206 mot Tet. Due Owe) safe fecor he scan tine of pare and ara in bck indeat Far $909 [TRANSPORTATION L SUBSISTENCE 7 ‘Crh Travel Expanses 4 os T878 — = ae Renae a : ets 830 Dany Prvate Carag Soma i at === caste t is Tao PRET om ohm setae AoA Ree tow ; RECEIVED ghidid €1 AWW HcHoue com 730 faatocaeeoatwtad ener MAY 17 20% g199W N39 NI 0.938 Ba * Form CNTR 009 Reimbursement of Travel and Other Expenses incur in he Discharge of Oficial Duty Ferm Struct last revised uly 2038 NC Department of Puble Safety, Dion of AéminiistonTRAVEL (show eon) Sly visted) ~[ TRANSPORTATION: SUSISTENCE 7 Die Tevel pense i Fos To. insists | OuLOFSae [2] —insinle | Outi Sais | —Explanaten | Amount "TOTALS BROUGHT FORWARD 0 = = Tae 330 Depa eve [Say Prove (Bay Private Cor Mingo Bay Private Car ape: Daily Private Core % aaa aie Daly Private Coriaag Daly Private Cor hea 3 O30 Tal Tapa shy Prvale Cage “8 ‘ay rane car ieege srs o Private Car Nieage 3 [oa Depa ‘Ave (Day Prive Car wieage (Diy Pivate Cor lesge 7 Tapa (Baa Private Carwiteage Pavate Gar weage @ Danae [Day Prose Cortaeape [Dany Frvate Cariloage 3 Depa Ave (ay Prvaie Cartileage [Day Private Cor Nae 2 Dap [Day Private Carniveage ‘© 030_Tm [Dea Private Car niveage z Dene (Daly Pre Car Mreage [Day Private Car Ni | =|SfzlllelS]=[>)- ole} =lo[-lelS Capa (aly Prvaie Car cage Dei Private Cor ieoge la Tour 5 Total jade Touartaae Ea 330_mi 575 1] GRAND TOTATS Tea, Feu GNTR 005 Reimbursement of Travel and Other Expenses incurred in the Discharge of Oficial Duty Ferm Sucve last eve July 2018 [NC Depertment af Puble Safety, Otasion of AdministrationREIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. 14116305" orignal roc ps and ohertopporira doe or xrrcorse Compt So, SOMBAry assunt ISrcsuan st ye aoc Papeete [Pajes's Werk Phone Number (919/733-3871 Reimbursement fr approved taining expenses must be submited to OST. Tai tasty ‘TraweniSecton ~ ] Law Enforcamant Division / State Highway Patrol 55. _ Tie [Location Name Number [200 1 ftount St Trooper 1 [Raleigh Sit ety, Sate, Zp) ermal Warking Hours (roma) Period Covered by tna Request (Tonto) Raloigh, NC 27601 [ita-tip sriig 146 seins Date LIF FEZ [Soparvear Telaphone #) — 1 ‘oot 000 008) 0004 “on08" 0906. 0007 0008 009, raat ie fs wae, fed APR 0 2H afe3/¢ 8 casa icblinbcin Sat nad Tae ae a ea RRTATO SOS a 7 InSite | Out-Of State [2 in-State On OF State Exolanation. “Amount, : Lee = 8 ay Pr ‘osr ial PT a i730 5 Tost ‘laa - - [Daily Privaie Car Wileage: @ 035 im Pe _ HD [4 Total a ome tart — Sa Liana “RECEWED Bde He? aos: oyna ann yap 29-206 ae 5 Accounting D- Drner $2130 NC DPS Aes _ Housing (Room _ $720 Form CNTR 003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Official Dury Form Stueture last revised July 2015 INC Department of Publ Safty, Division of AdministrationGer Tate Explanation SUBSISTENCE: TrStale | OW OFSate +1370 a0 TRANSPORTATION TnState | Out OCSiate TRAVEL chow each Gy wed Fron To. TOTALS BROUGHT FORWE Day ae Depart [Daiy Private Cl [Daly Private Carita Depa Arve. [Daly Private Car eae [Dany Prvate Gar Muesge: ta Teter is. Total Depart arive ay Private Car aage: [Daiy Private Car ueage Depart Arve. ay Private Car Wiaage ay Private Car Mies Sf=lel-lel=)=lol-lele}= [allo ll=lo[te a aly Private Car Ne aly Private Car hea Depart Arve [Daly Private Car Wenae [Dany Private Car Mieage: Teta 5 Total Depa Arve. [Dany Private Car ig [Day Prvate Car tleage Sapa Aitve Day Prive Car oops: Daily Private Gar ieage: [5 |-|=|S=|e|-l=]S)=|o[-lalaslola ol al a ive [Daily Private Car Nag: [Daty Private Gar hue Depart Ait [Daiy Private Car Weage [Daiy Prvate Car Nieage Depa [Daly Private Cor Wea [Day Prvate Car Wiseage lel-lelS=lel- lol] =lol- lel e}=lole lal Depart Aire Daly Private Cartage: Daily Private Car Moa Talat Tota [aS Tort Mae 730 2.575 a =| =lo[> [a] =] )o|>|=] ~|[o[>[=}=|elo[> la} o| olol>| =} | alols|al ol alo! Form CNTR 003 Reimbursement of Travel and Other Expenses Incurred in he Discharge of Ocal Duty Form Svuctur ast revised July 2075 INC Department of Pubic Safety Division of Administration aiciREIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED 14116305” Z IN THE DISCHARGE OF OFFICIAL DUTY Rant Siti one erga to General Azeaunting Atcha necessary orginal recep sd ot Poe reqsraon lodging a5 out atleouey Ware. Reta 296") cy Foster nan 30 ay ar moni ence. Prepare in ko pe Bix Prone Number _(010)733.387 nal, Last) [BwveiorvSecion ur rears. Complete amour, company, coun upporing dosarertso fe orm nourg ary pre Reimbursement for approved raining expenses must ba submitted to OSDT. _ _ __|isw Enforcement Division / State Highway Patrol -EPD 7 Tite Inber |200.N oun st Trooper _ leigh 5/1 ity, Sate, Zp) Normal Warking Hours (rom) Period Coverea by tis Request Wome) Raleigh, NC 27601 Ba-8p lrr2r016 - 27572016 ‘Unie pao pos RTE Hae BT Ea TORE T No aims LUNE No. account ‘007 0902 0008. 008 0005. 0006. 0007. 0008) Ee = 5 s 5 s 009 Total Expense [$122.00 Lese Advance 2 Tot. Due (Owe) [#2200 Coal Ash Commission Stipens # Days 315 $0.00 = 830 $1090 1870. BHO Depart are. [Dany Pruaie Car Meage Dally Private Car Mea Bias Dear ar 220. 70:90 18.70 Dally Private Car Meage -L Dany Prva 7 Bras S830 Depart ‘s_7090 Art. Ss 1870 Daly Private Car iieage —__@ 0.30 (ay Private Car iloago: 0575 mi = 37 ‘GRAND TOTALS $13.70 — 1G) Type of Subsets in Sato (1) Mode of travet: Breakfast $83 Jp-Prvate Car O= Ofer, rai bus te, cakng oes R= Reniaicor cw so D-Diner $1870 outer state B Grositst 3320 Hi Housing oom) _$ 7920 Form CNTR 003 Reimbursement of Travel and Other Expenses Incurred in the Discharge of Oficial Duty rm Structure last revised July 2015 © Department of Publ Safely, Division ef Admin syrsale Ihave ghen papper orovamp tas so TRAVEL [Shows each wie TRANSPORTATION | SUBSISTENCE Day inSwle | OuOrSate Sele | OutOr Ste Tra sno a FDU suet and coy Wat Te [ATS AIT Diner Travel Expenses Explsnation | Anant ls Tota 5 Total la Tatar 5 Total 4 Tata Tota a5 Tom Nee Ex Mor: at at sions‘SUBSISTENCE TeSiste [Out Sas 11370 20 TRANSPORTATION In-State | OutOF Sie TRAVEL (anon woah oy WaTeG) From To, TOTALS SROUGHT FORWARD. z oR 12/29/2015 iene a ‘are. (Daly Prvdie Car Mleage. @ 050 I [Diy Private Car Milage (pate Depa ‘aa [Bay Private Car eage [Day Private Car Mieoge: 7 Depart ‘ave [aly Private Car taoage Dany Private Carne o Depa Arve. iy Private Gar Mileage: aly Prvate Car Mileage a Depart ‘Arve (Daly Pivate Car tieage [Day Private Car Mieage 2 Depa ‘rive Daiy Private Car taaage: [Oniy Private Car ue 7 Depart Aire Dati Private Car Mies ay Private Gar Miley 7 am ‘rive aly Pivate Gar Mieage aly Private Car Maeoge: 2 Depa Bie [Day Private Car iene [Day Prvate Car Mieage: 2 i Arve [Daly Private Car Wage [Dany Prvate Car uta 7 Deg ‘Aitse Daly Private Car Wien Daly Private Car Mieage: 7 Da Arve. iy Private Car Wieage Private Car Miteage l= l=l=]S)=|=)-l>| Sf =lel-llS)=[ollelSl= tolls Tovar Tota 5 Total as Ey ‘730ml 0.575 /mi GRAND TOTALS Pa Form CNTR 009 Reimbursement of Travel od Other Expenses Incucred in the Discharge of Oficial Duty Form Structure last revised July 2015. [NC Deparment of Pubte Saety, Division of Adminstration tinesGewtve Debt NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED Sena of PORT IN THE DISCHARGE OF OFFICIAL DUTY. Uy) BGS INSTRUCTIONS TO CLANANT. Si SO atonal vrstan approval feces epatin [Payoo's Work Phone Number __(@10)799-3871 Reimbursement for approved Waning expen ae a ial Last) isentSecton Te ~ ~ 239 2 Tal ccouning, tach al racheety orga! recaps ana oe ‘tettreourty tava. Reta one (1) py fr out ecods Complee ou [200 Blount St Trooper [(ciy, State. Ze) Normal Working Hour Trornto) by Bis Request (rary [rzaaign. NC 27601 laa 972018 912015, Tine pos poy ca Boo we Sas SOT aT eB a ae SRT SET aN Ty TT Ea OTRO F inna expense an atonancar nesrein ne fece he Sine, ar ey ica hve gen or prea ovr andre arson vee Tate) 42-3571. (Sisecvser Teenhore a oon ‘0003 ‘oo 005 0006 G07 ‘008: a Tain eas ar Tess advnce GMs Tec Due(owe) [3750] facade actual in of departure andarival hocks Ineated, 9 Ca Ash Commission Spend Sion is som fa Day 715 Depart ‘Ait. [Baiy Private tar cope Daly Prvete Cor Micone wars Ciher Travel Beplanation "TRANSPORTATION TnSiale | Ou O1Sate ‘SUBSISTENCE Sete | OuOrStae “Amour TRAVEL (Show eat ciy vated) rom To @_ 030mm 575 ini [Day Private Car taeape For 2 Depa - L = co Toa [Day Private Cor Wenge 030i Dally Private Car Mileage 0.575 ai] Tota ‘GRAND TOTALS S350, aE Toad se (2) Type ot Subsistence: in Sate |) Mode of Travel 1B. Brooktat $330 Jp-Prvate Car 0 Ciera, bus x, paningtees AZAR R= Rental Car L-Lned $10.90 D-Drer 31870 |MOTE: Cay ttl tor subitence SEP 24 205 Housing (omy Form CNTR 003 Reimbursement of Travel and Other Expenses incurred in the Discharge of Offial Duty Form Structure let revised Jy 2015 epariantof Pub Safty, Divison of Adminsration REC'D SEP 08 2015NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY (Cee INSTRUCTIONS TO CLAIMANT Submit one orginal fo General Accounting itach ail necessary orignal receipts snd other supporting documents to ths for [Payee's Work Prone Number 919-753-367 - ial, Last) Payee agaress (Steet) ON, Blount St Trooper ee | iy, Sate. Zp) Norra Working Hours (romvioy T Raleigh, NC. 27601 HAP " [Reteigh — aod Covered by hs Request (ranto) Tea 6 —— 7 Total Expense [$7200 ance OKT, rec boe (Gen) [E——wa0] e/a} ly oi ir Travel Expense ‘OutOFSiaie | —Explanali Anmounl Coal ash/Commission Spend # Days. nsIs = 0.00 TRAVEL (Show each oly wailed TRANSPORTATIO TeState 70.90 Ds From a [reaps Depp [ay Pete Cap Meage [Day Prive car tone Tag Depart Day Priva ar teas [Baty Prvaid Car Menge TG arte [BanyPrvate car wieage [Day Prvate Car Mieage = ia Tota 5 Total 030 Imi 575 ED 320 1870 ia Tota Total aa 330 70.90 18.70 @_0.575 Imi is Total [aE Tora er CEE! @ 030i (@ 0575 mi GRAND TOTALS = 3780 311370 (2) Type of Subsisen vd a Siem S90 or: opments rn | Form CNTR 003 Reimbureersent of Travel and Other Expenses Incuted inthe Discharge of Offical Duty Form Structure ist revises ly 2015 [NC Department of Pubic Safely, Civsion of AdministrationGier Wave Expenses Tiplanation —| Amu SUBSISTENCE TeSiste | OW PSS Tao 630, TRANSPORTATION, Tn-Swie | OutOfSiate TRAVEL (ahow each cy aed) 7 From To "TOTALS BROUGHT FORWARD. z Da aie [Daly Prvaie Gar wieage Diy Prvate Car Mica Capa Ave ily Private Car Mileage: @_030 il Pavate Car ileage- Depa aire iy Pivaie Car Meage aly Private Car Mileage Depart Atv aly Private Car Mileage: Private Carica 2 Depart arte ay Pvaie Car Mage: 030ml iy Private Car Wenge a lol l>|S= ol [ol =[ol-folSt=[2|-le [f= lola Dagar Arrive iy Private Car Wi Private Car nleage: 2 Depart rive [Day Private Car Mraage [Baty Private Car Mea 7 Depa Aire (Gay Prvate Carte [Dany Prvate Car Mica 7 Depa Arve ay Private Car Meas iy Pevate Car ileage 7 Depa _|— art aly Piva Car Mage [Baty Prvate Gar Mies 7 l>l- [|S =l21-[=[S]=ll-lel=}=[ol-lole]alolcietsl Depart ‘Aatve [aay Private Car wean: [Daiy Prvate Car Mis 7 Depa Bite [Day Private Cartage Daly Private Car Mieage Tatar Total lado Tom Mee Be Timi 0.575 imi GRAND TOTALS Form CNTR 003 Reimbursement of Travel and Other Expenses inoue inthe Discharge of Offical Duty Foam Stuctre lat revised Jly 2018, [NC Department of Pubte Sate, Division of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY “eeu “~ ® REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY IAVUG3oR Tor one cignal to GerararAcoouting, Ataeval recess oigholecalps and oe! supponng dosuents oie om, Fa sing, an autteslateounky Yavel,Reain ne (1) cee or your recorss. Complete amout, company. aecou, and cnt sry caye aur movin ons Prepae nore Fone Nomoer @1B)7E071 Reimbursement or spproved ining expenses must be _ Fe i, Lash DuatoniSezion ‘aw Enforcement Division / Sate Highway Patrol PD hie _ trooper IRalegh si Ronmat Working Hours (Fomto ]Paid Covered by is Request romtoy sa.89 T2018. 12318 Te THs SRE a A TST F Zope nove gon pro aor fx cxamgh ave sar eb aoa | a= Taal Ears tees Aare pee Toc Due(Owe) [8 lalis™ TRAVEL (Show each city visited) TRANSPORTATION. ‘SUBSISTENCE Travel Expenses = ne ae : ae Sa z ie ee a8 — ep oe Nicer: Mr, a or to ioe EC U8 205 H-Hovsing (Room) $6730 |notioercsed aunonzesamunt | Announts Payable pone ee femmes rennesgorenotecnmenainminteoetonsions Oo AEN DED 91 ane Form Structure last revise July 2015 NC Department of Putke Safety, Dvsion of Adminisvaton— 3 TRAVEL how each cy vated TRANSPORTATION SUBSISTENCE, a oi From To Swe | Ou-OtSae |Z] —inSae_[ Cu0tSa | — oa < TOTALS BROUGHT FORWARD 3650 v 300 ETE Depart fae Baty Pre Carteage Dai Prva Tea Depart ‘ve — any Private Cartage aay Private TST Depart ie iy Fale Cio iy Pr Tia ‘asa fae iy Prats Cara Day Private | Desert aie Dany Prva Careage [ai Private Cara Tae TaNS apart Arve Day Private Car Nieage: Daily Privto Car Nloaae THs0s Deport Daily Private Car tiveage Daly Prvate Car heeage: ens Depart ‘Arve [Baiy Private Car wieage [Gaiy Prvate C Tears Depa ‘Aire [Bay Private Car Mieape: @ 030i Daiy Private Car Micouo TZ ar Arve [Day Private Car Wieage (Diy Private Car Mileage 12a Depart Arve, [Baty Prvate Car tiieape [Day Prvate Gar tieage: ell=|S=le1-[=|8)=I5]-|=]S0=[ol-l=lS[=[ol-lelaf=loltelalsiole 1a Toa 5 Tota [=| | =lof>[=| =| =lol>]=] =| elol> la} lo ia Tova is Tata el-elSf= lst fo[ Sf =lol-lelSle lol Statolatet isto is Tota [ats Tors Mise Be Soa ml 0.575 i GRAND TOTALS =| =]0[>[2] =| =|o}>]=] =| vlol>|a| =] slob: EET Ferm CNTR 003 Reimbursement of Travel and Other Expenses incured inthe Discharge of Ofcial Duty Fem Siructure last revised ly 2015. [NC Department of Pubic Safety, Dision of Adminstration sone ‘ernest: Evecubio: Meteo NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Mi 430s” TNSTRUCTIONS TO CLAMANT. Surat re oignalto Gavel countng Atath a pees, oil esos ava che spporing don fs erm reagan prot frien agora of exces epson copra ara outta Fave Rolain va (1} copy you vecaras Corte aur, company, account cee felts. Flat ast ny and matter tan 30 daye afr one repae mak 8 9p —] [Payeos Work Phone Nom (ov9}755-3871 — a Trooper Reimbursement or approved reining expense orp DnisoriSecton EE Lam Enforcoront Division State Hightay Patrol V Tie E Nort Narva Wang Hours (rome) Paiod Covered by ths Request (rom) — Key Sale, 26) [Ravign Nc Z7600 oat SONOS 10/15 Trae SRT TRU ROSH RTE cH TTT PTs TOSOOTE ba 929) 733-387 ‘Guvervisr Tepe sonsns 2 2 7 \ 0 05 Wn Loss Advance Tot Ove (Owe) ae Record the actual ime of departure and arrival in blocks indicated. Coal Ath Commission Stivers Soe ee 000 TR Gore ae ASOT SRESTERE hero —] Tse] On ocSae [7 —sae | Gu OCSa | — Spoiler] ena af tye $ ot} — set —+ 7 +t — ra = . ater 5 at rt a 730 tts—T930} ¢——— — a $ 3 | oan mt a ast Gai bral Goria Tere mal F o—— Tai Depa] = ni — - ==] me 3 t a Sat ete Carnage ——— 03a 7 oar Sai Prt Car ivan area a ia T GRO TOTS a is Ta | Type a uence ETT Jocewens ca "0. nec es. te pang nent c Cen ewe ©: Omer $1070 | lore: ost tat ssa RECEIVED cingmoen tse | (ct tren PAID OCT 22 2015 ine S080 REC'D OCT 16 2015 orm CNTR OGD travel and Cer Exeres ncaa he care of fi Duty Fm Sucre eed 213 ‘Dare’ of Peake Sty. Dus of Adri abon‘SUBSISTENCE ms Ouro Se ‘Giher Travel Expenses Explanation | Amour TRANSPORTATION inSoie | OuOrSae TRAVEL eu ca oy wed Fee Ta. TOTALS BROUGHT FORWARD. =e [ay Price Car ioage Sosa Prvale Gar wieage: 3375 ml 3. = [Day Proate Car eage Diy Preate Cartage 2 Tae 3575 imp P Bae e [Day Proce Car age Tam [Day Private Car We 575 an Depa [Day Pate Coreg [ose Private Cor twenge lol-lelS|=lol-le[Sfelolel=| a= lol-lo| Tm m1 Aare rivals Cat Sa [Day Proate Car Mig Tn D875 a Private Car eage: Daily Private Ca ieage Depa Day Prnaie Cor eage Ca [Gay Prvate Gar Mieage a Tatar Tota Depa Bee [Daly Private Car Wage [Day Prive Car Minne apa ie [Day Poste Cabo [Day Prvste Car Mieage Depa [Day Private Car Wage [Day Private Car Depa Te Davy Private Cari Daly Private Car inane: Tear Tosa Ps ay Private Cartmeage [Dai Private Cor We la Tas 5 Telal ICES @ 036 T 3575 in] GRAND TOTS = A, a 3 z A = z cI 3. P é a ar TH aes Form CNTR O13 Reimbursement of Travel and Other Expenses ncuredin the Discharge of Of uty a Foam Scr ls vevsed Jay 2078 2 INC Deparment of Pu Safty, Dusson of Admristation saisHele 5 INSTRUCTIONS TO CLANANT. Submit one rene of exces regetationlospno, imbor _(919)733:3871 | _ [Payee's Work Phone Reimbursement for approved Waning expenses mest Deecafur Obst NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY j REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED | IN THE DISCHARGE OF OFFICIAL DUTY 14 U9 30S" rato Genera hecauveng” Aish al pcessatyongnal eonp Tes om neg ay aor suonnearoosory] ia ia tas) Bsarsecon ee Pe Escort Division / State Mighray Patol are i es) Tt ect anie so ur po segs rat Wang Ras TORTS TPaiod Come yb Tog an ti 4 \Giy. Site. Zo) [Raeign NC 27601 ea-tp iinons 11042015 cc ut BI en sy —_ ‘ SHO are! | Ss : PEE tt EE Talal Expense Lass Advance [epee geod J Tet Dve(Owe) [SCD asa6 Coal Ash Commission Stipend ‘Rocord the actual timo of departure and artval in blocks indicated. Ferm Structure at rewsed July 2015 INC Department of Pubse Solely, Dision of Administration | RECEIVED |e a orn GH O03 Rebnburee OW ads 20) Src expmses named lacharge of ict Day pec) NOV 04 2015 favs, x35 50.00 RAVEL (Show coo Gly vied) TRANSPOR I SUBSISTENCE [—GierTareloemes —] ate | Outre TSiaie planation] AmouAT Wis = apart To ie 2130} = | ay Day Prvate 3m L | Fane] = | Depart 3080 Tre a —t Z130 [Day Private CarWeape Cm z 1 | Daily Private Carhtieage S57 inl F — = 4] Tas z = a ] 7 Seed — | Day Pte aes eos ra | Doty Private Garage @-0575-mil PT S50 [To t GRAND TOTALS on as Torna Ep — 9 Mode of Yave | DO Nore: oat attra | Cotaren ]‘Cire Travel Expianaiion ‘SUBSISTENCE Sie | OurOrsiae 37.90 TRANSPORTATION | Ou OFStale ‘TRAVEL Ghow each omy VSIeG) = From To TOTALS BROUGHT FORWARD. = Depa rie [ay Private Car Wieaae [Daly Povate Car Mileage. Depa ‘Arve. (Bay Private Car Me [Daly Private Car tor Depa Ave (Day Private Ca Menge [Daly Prwale Coc Mea Depa ‘Ave [Day Private Cor Neage [Baily Pavate Car Nieage. tl lelSf=lel-lelslz torte Da ere {Day Prvate Cor weagon [iy Private Car nieage” Bapaa Arve [Day Povate Car eage: [Daly Prvale Car leoge” fa Taar [5 Total apa ‘Arve [Daiy Prvaie Car hioage: [Diy Pate Car neg lel |=lap=[o|-l|5) Ei Depa (Gay Private Car Mieage: [Day Pvate Car iieage: atom 5 Tova Capa ‘Aawe Day Prvate Car nieaae” aly Private Car Mileage Depart Arve ay Pavate Cr Nieage 030 ii sly Pvate Car Mieage: Depa loll ]SI=lol-l=|Sf=lol- lal rive ay Private Car Wieage: S030 la Tovar Total (Daly Pvate Car Miles ‘2.575 im Depa ‘Awe [Day Pate Car meape [Daly Pevate Car tm fa Tova [5 Tota [AES Tota Mee 050 Tal 2375 GRAND TOTALS Form CNTR 009 Reimbursement of Travel and Cine Expenses incurred in the Discharge of Official Duty Fim Stuctre lat revises ty 2035 NC Depariment ef Pubic Safely. Division of Adminstration aiNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY_EXe¢ ‘aren spprovale exees replat lodging. an out of talsouna Wavel, Ratan on (1) 2p for you feats. Complete arcu compar account and conte fle Fle a lost monty and ot ater than 30 days ster orth eras Prepare nike Ype io Phone Nurber (10739-5671 Reimbursement for approved Waning expenses must be submitted to OSOT. [OwatonSecton Law Enforcement Division / Stato Highway Patral - EP Tie fe Naber [Nermar Working Hours (rorey Fe Covered by Ronn om sins Trav en agus ove Ys we eae Heroin en, Sa 76) [Ragen oon teas He ca aemta cae Th Peres Caee Sere amrae nrey Datey Superiser Teleprone ‘D001 7 = 0002 Lielslels 0008. 008 0005; ‘0906- a007 2008, 000% r ola Exponas [$3700 Less Advance 24 fff ofa r We 21 THs ast pe Tot Due (Owe) [$27.00] ‘Record the actual tine of doparture and arival in blocks indicated, Coal Aah Commission Stipend # Days ess = $0.00 (Show each ciy vated) [TRANSPORTATION rem Te in-state | Out OFSiate ‘Ciher Tanvel By Explanation ‘SUBSISTENCE Tstate [Out ESE oa ‘Bers Depart ‘Ave [Daiy Private Car Day Privat wits Depart ‘Ave [Galy Prva [Baty Private Car Vieage r aa Depart 5 a = z ar i 0.575 tn Te © Dany Private Car Mileage: 0.575 mil 1 Dome $2130 | [touring oom 7020 | Form CNTR 003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Oficial Duty Form Str ie Dopurmend ef Pus Sefgy Divan of Adrian REC'D AUG 12 2015Execute Debt NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 14) |_ (ole) Taring_ tach al necessary ong! reps ord ther ugporg doa to hs fom, aaea) Your recat, Complete aout conpoty, assunt ane ane fees Peat INSTRUCTIONS TO CLAMANT. Sumi one aigralio Gere) A auton ans nett han 30 day ar meh nas Prepare me Reimbursement for approved raining expenses must be submite to OSD. Payers Work Phone Number (aia)fUa-3871 [DwsniSecron Law Enforcemont Division State Highway Patrol - EPD| Payoes acess (Steet) Tie [200 N.Btount - pet sigh Sr " (ty. Sate. 2p) [Norma Working Hows remo) [Paiod Covered by tna Request (Famney (eaeign No 27601 lst _______atazoig-era0i5. zens Tato Exoense | $122.00 21 tS Less Advance \ 4 Tot. bus Owe) [E——7az00 T pw Coal Ash Commision Spend Days wes = s000 — ~ TRAVEL [Show each oly visited) "TRANSPORTATION ‘Other Travel Expenses Da om Toe [1] —inSise | Out OFS Eaplreton [Amu aes o t [Daiy ovate Ae 7 teat By Pr Bars im] EO Tot apart Hy t {soso Tf ate 3 —e OPK Day Prva Carne qo rape ¥ Ct Tam [Day Private Corte 2575 mile i EE 5 To aes @ ets 330 + [te a = Tes ——7os0| <\— ae o[s——1870 [Daty Private Car tose @ 630m ——T = le Tower = Daly Prvaie Car thieage 3576 ml ie Toss = TRAN TOTAS Pian as rote gt — | Type oF Subninence Sate Jat trae @ Besta sea Pitre Car "0 Ober ibs. tn pningtees A=A R= RealCor Co inen row || D-Deer 5137 ROTE: osiytet reunion Phen (Room) $6730 [are ecand sanarea ama PAID | oman _finsoeeratateern | sep 11 208 ed Hitosing Reon 37020 | Form CNTR 003 Reimbursement of Travel and Other Expenses Incured inthe Discharge of Official Dy Foo Stuetue last evsed Jy 2015 NC Department of Puke Safety, Dion of Admin“Ciher Trowel Expenses Explanation | anount ‘SUBSISTENCE TeSiale | OutSiaie =i — TRANSPORTATION Tr Sisto] Out OFS TRAVEL ehow each Sy vaste] From 3 Da Ss 30 Sepa [Day Prime Car meage Day Prva cs mas Depa ‘Ae [Gay Prewte Car Wenge C0 [Daly Private Cos Wenge @ ave Day Prvate Car Wiaage eos Daly Prva @ 0575 mf P 0S [Baty Private Car eng Ta Toa [Day Preate Car eleage 5 Towa ‘Bas Depart [are (Onn Prva Car ong [Daly Private Cy Depa ive Day Private Carnieage (oa aaas Depa iy Bivate Care [Daly Private Car wage WaT Depart [Day Private Car bape a" ‘Waa Depart Bre [Oaiy Prvate Cor ioage [Daly Prvate Caritioaye waa Depa ane. Daly Pate Car Miaage [oaiy Prvate aes [Daly Private Cor Menge cI la Toa is Tota Eom 0575 im GRAND TOTALS Tar 5 Tot [aes Toa ee [San Private Carnmeane © é 3 > z o z 2. [bat Privave Car Neage E Sle) [= 1S =[=1- [eS] =[ol=|o[ 3] =|>1-lol S}=[o1-Jol2]alolcllalslorclo Ee Fein CNTR 009 Reimbursement of Travel and Oper Expenses Incured in the Discharge of Oficial Duty Form Structure las roused aly 2015 INC Departnent of ble Safty, Division of Administration aoe BO ie ONINSTRUCTIONS TO CLAMANT. 5 NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. (4 © BLS mone orgralio Gene's Rerouning Atach al recess crgialrvepls an oer upping socarens ots om ncUaing 37 then approval of escessregsraton gen, ana eutotsattuny Wave. Ren ote I} pyr your recats Congile amour. compar, socount, and ener Fs. Fat Pr at 3877 Reimbursement for approved training expenses must be submitted to OSOT. | Crecubie pa 200. Bun | “trooper Rdieigh 5/1 (Gay 3 Norah Workng Hous (Fem) Ralegh, NC 27603, ato [Paioa Coveres by ths Request oma) jos7201s 8212015 Tae aS Ea st cary als TOR uzarns pate. 919) 723-3871 fSupe'wscr Yetohone 8 - [= z Pt ersperrret oo s Liatents: za t ate fat . Tt ts Fa = $ = T 5 C — Ets ct i | FE 1 + a J I Taal pe E Less Advance “is Tot. Due (Owe) ql Coal Ash Commissic Days _— $0.00 TRANSPORTATION [siete | Ou FSi [Bay Private [Dbiy Pevate Cari 20 ‘apa ave Tah PrvateC Daly Private Car Meeps TOTS Depart (bay Pre COP [Dat Private Car Mieage 0575 ml Housing (Room) outotstte 8 Besta PAID erp 11 206 Lien eon ks) mode of trve: fePrete Car O= Omer, tut ae ping ens A= ie Foi CNTR 003 Reimbursement of Travel and Other Expenses Incurred inthe Discharge of Oficial Duty Foi Struct last revised Juy 2015 NE Depariment of bbe Safety, Divston of Adminisaton ‘SUBSISTENCE Siner Tael Expenses ‘OutOr Sate —Esplonaton | the actual time of departure and arrival in blocks indicated, nm a Toa 5 Toul 5 Total ais Tom a= Ey | | { Iiore: Dy ttt utssence 56730 |rettoescees hood amount, RECD AUG 31 2015‘iar Travel Exper Exgianabon [Beant ‘SUBSISTENCE TeSiate_ | OurOrSae e610 TRANSPORTATION inSis [Out TRAVEL (eho each Cy wie) Fron, To STALS SROUGHT FORWARD, Sav fz = Teas ave loney Private Carniasse: 030 im Day Private Car Mie 0.575 mal F Depa (Diy Private CaF BRE Dai Private Cori Dapaa ‘Aare aly Pre Gor Wieage: iy Private Car Ml Bapat “ee Day Prive Gar Wage @_030_iml ally Private Gar Mileage [Daly Prvate Cartaeage [Day Private Car Mea ‘030 Tal 2.575 im Caan ave [Day Private Carnes Baty Private Cor Nieage, e030 2575 im [Day Private Car Daly Private Car Mi 7307] 0.575 ml Dea ‘rive Daly Private Car Tieage S030 Ta [baayPevate Cartatoage @ 0575 mi Depa Wee ay Prva Car Meags @ 0507 (Bay Private Car Mil 0.575 imi Depa iy Private Car [Daty Prvste Cor Nae Desa ‘ie [Dany Prvaie Car ieage eam [Daty Private Car weap: fel f=l f=] ol fol Sf =lol=fal f= ol-[alSh=lel-lelSllol-1=| fatal | De ‘ate (Day Pate Car eage [aly Private Car ie fara [5 Tota [as Toul wise Ep EI 0.575 mi ‘GRAND TOTALS BD Form CNTR 003 Reimbursement of Travel and Other Expenses incued in he Discharge of Official Duy Fim Sirvture lect roused July 2015 INC Dezertment of Pubte Sofety. Chain of Administration Si Wadwen appva cf excess region 109g 2nd NORTH CAROLINA DEPAI RTMENT OF PUBLIC SAFETY IN THE DISCHARGE OF OFFICIAL DUTY TNSIRUCTIONS TO OLAWAANT. Sut] one pray © Genera Accouning. ARC al raceearorgna Tecate and che supporrg soceris fo Wis lo noun any ro" ~[onrsianiseston Low Enforcement Ovi or you rears. Comte aro sion i State Hi Exeuative Debt REMGUREEMENT OF TRAVEL AND OTHER EXPENSES INCURRED, Hi ede 200 N_ Sou St [rie Trooper [Raleigh / St (ty, Site. Zp Rolegh, NC 2 ba-8o (rang owe Fiod Covered by th REGIE OTTO) 312015. ee SEE | = woot TT 4 Listsleiate zs — statis $ —E-FB AH roe 4 $ i st3 : t = t L or om J j08 Te Bue (Owe) Roc ture and ar we Cal Asn Conmasion Stpena sone wos 20 TREC Gar aa Sy aaa TONSPORTATGR sre OherTae a Tene | On orsae | eT —TeSue | Sursae | — Samaria | meme 5 [-——s ha Sa ie Mage gO — = a { Fo Se ame Sr Ea To ae ote — sar} Depa t t nae a D a ‘ Fa [air Pris Oe Megs >> oe TH Toil [oapea i — = Rie 3 a [Dany Bie carwaeage——@e-030 Aa > Lip { fra Datel Car Misge ————@ 0575 rl F a fe Tat TAS TTA | a] »|=[o]>[=]~|=fol> =) =| lols [a] =| =lol>[=] =| elol> lal =| olob lal olelol>lat=| olalstalal alolotat aor Form CNTR 003 Reimbursement of Travel and Other Expenses Incuedin he Olcharge of Oficial Duty Form Stcture last revised July 2015 NC Deparment ef Puble Sal, Dusion of Admevsiration roa Le ana aigNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. 14 LU3US" INSTRUCTIONS TO CLANANT”SuDmionecrgnal to GereralAccouning_Atacnal neessan orginal recan=and cher evnsomng eilenaperov of case regttaren caging. at out ot ttle ave. etan ane (1) py a your records Completa arc eamoany ronan net ater than 30 dye te" mort ees Prepare Ah or ye © Payeos Werk Phone Numb i Reimbursement fr approved training expenses must be subrnitied to OST. IDivaoniSecion rite B Nomber Trooper (cy. State, Zip) oral Working Hours (romToy [Parod Covered by tha Request rome) — Ralogh, NC 27601 loa.ap 52015-12015 ny TGR RS ToT To eayresipsleaicpeimal opel cikssbidmprinccinecld wonone rigor Teloprene #) ‘0001 T oo rept z 5 5 3 ‘003 3 t 5 = 5 s = 7 z ‘ooo on 006 0007 D0 aa ‘Foal Expense Less Advance Tet Due (Owe) mmission Sipena 515 [TRAVEL [Show ooh ay vse) Day Tom To TS. [Coepad SUBSISTENCE] “ther Travel Expenses ‘CuOtSiate | Explanation ‘TRANSPORTATION Tn-Slale— | Ou OFSiaie [a Toar [5 Total Baty Private Taras [Day Privat Dally Private Car Nileage Depa Daiy Private Canieage 050A DaiyPruaie CarMieane 7575 mu GRAND TOTALS RET 5 Total iaes Tors ee Ep! ec = (2) Type 0 Subsistence” Sia 2 Boohest | +) odo of rave: ‘bust, pathing ees AAW R= Renal Car RECEIVED DEC 3 0 2015 Aah ery Feim CNTR 093 Rembursement of Travel anf HD ENRese BEA te Discharge of Oficial Duty Frm Structure lst revised July 2015 ent of Puble Safely, Division of Adminstrationai Scecutee} Petal tele NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED ssn IN THE DISCHARGE OF OFFICIAL DUTY 14 aus” INSTRUCTIONS TO CLAMANT” Gubmitone ongralto Genera Accounting, Alach ll resessay orignal oepls and oe’ SuppOnTG tnten apart excess egstaionlocgng, ond oul siaeccuney travel Retan one) copy you feaass. Complete amount (oi9733 3877 Reimbureament for approved training expenses must be submited to OSDT - rite Jeocation Name & Number [200 N. Blount St Teoopee Jrzaeign si Sale. Zp) [Normal Warking Hours (ammo) Peried Covered by iis Foquest(rorioy [Raleigh,NC 27601 sap _ topes 00075 T ] 7 —_ a Bayz] T T sma Tae ster Lay 1A E jar stafetriate AA hee Ty te | $ Tspate $ I sts tC er 1 ee 7 f Tats Expense [Sa - - — a Less Advance ales Tot Due Owe) ¢ Coal Asn Commission Spend OO —————— #Days mss = pe 1 2 SISTENCE Giver Travel penses —] oa 0 TnSiale | OutOVSiae_[—talaraton — [meant (Daly Prvaie Car teage a0 Tear = [Day Private Car tinage 3575 5 Towa x [Dany Pr ern Sear vate Car Mleage “@ 0575 mir 330 5 Tova Depa 3 — Atte ——— ret Pra CaP EH ml ep — 7 - Daly Prva Car Mileage @ 0875 Im] Ft | ‘GRAND TOTS t T = | ayy at Sunstone: State 1) Mode of reve: 8. rekon sen 8 Bresvaet, |one: Day totter subsistence RECEIVED NOV 12 205 Se Te wor 0——-SUBSSTENCE ms ‘OucOrSiate ‘Giher Travel By Expiration ‘moun TRANSPORTATION r-Staie | OROTSAE TRAVEL row cach Sy vated) % From Te. TOTALS BROUGHT FORWARD. z 70 Dapaa Arve (Gaiy Private Car Messe: C30 [Daiy Private Car @0875_mi Depa Day Private Ca ge [Gaty Private Car Mie: Depa arn Daiy Private Car Menge: [Day Brvate Car Maeage. 730 0575 lele| Ave (Day Pruate Carmieage e030 [Daly Private Carwncage: Depa ‘arte [Daiy Private Cartieage [Daiy Private Carthieage: apa [Dany Private CarNioage G00 [Daly Private Car Meage: Depa Davy Prva Car Weg [Day Prvate Car wieage: Barve (Daiy Prumte Cartes [Day Private Car wueage: De ALTve, [Daiy Private Gar iieage: [Daiy Private Gar Mieage. i Dey [Daily Private Care [Daiy Prvate Carntveage: stelle] Sf=lol-lelalzlol lola) Depa ‘ave ay Private Car Weage c aly Private Car Mile Depa aie iy Private Car Wea [Daiy Prvate Car Mieage: 050m 0575 mi] GRAND TOTALS BoD Form CNTR 003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Oficial Duty Form Structure las revised sty 2015, : [NC Departnent of Public Safety Divsion of Administration ei bsEre CATve tts Sieh s NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Mil 30s lel amount compary,a€coun. ana cere Neds Feat ‘ongnalio Genera Accouring_ Atach ai necessary onpral reps a and outa sation travel. Rete on (1) py for your ocoas Cor Payee's Work Phone Number Reimbursement for approved training expenses must be submitted to OSOT war aap] [DxiwonSecion Law Enforcement Division / State Highway Patrol fi J rebores ses erat Wor FE HST FC ys Ro FORT _ Soom 2ose0 on Te ere osenooareenenunoomarta Tanah aa eanaceat ea eereaeaa hi Ad Lacs (ate) C929) 793- SEL ‘Suierwsar Teepnone #) Tela! Expense Less Aavanes Tet. Dua (Ow Record the actuol time of departure and arrival in blocks indicated. Coal Ash Commission Stipend [ania R Sts eat He 1 oat : tt eee 5 oan [Daily Private Car Mileage e ror —_|5. Total _ Arve o T o Sb — [Day Private Car Mileage kT a la Total _—— De A x T ——_) ‘Arrive 2 _~ [Daly Private Car Mileage. 0575 ‘mil ~ . is Tol T means TH Has aS Eg ipo Sooners ewang eon pee LED umn OCT 09 205 | mee | | Weve oor) Fam CNTR Ons Reimbursement of rave an ter Expenses cued nthe Ochre f Of Oty NC Deparment of Pubhe Safely, Dision of Administration REC'D SEP 28 2015Cher Tava Explanation ‘Amour (SUBSISTENEE, TrSiate | OOFSiae 1370 TRANSPORTATION — in-Stale | Ou. OFSE YRAVEL (how ench ety vied] Fiem 73 i TOTALS BROUGHT FORWARD. z oa wwe Depart Arve ay Prvate Car Mieage [aay Private Car [eg [niyo Car [Bay Private Cor Em [Day Prvate Car Mes [bay Private Cor 7S Depa Arte Gay Private Gar Reape Dany Private Car Nas Tor is Tava ia Tovar 5 Total aly Private Car iveage: [Doiy Private Con Mucage: Tor [5 Toad ary Prvate Car teage [Daly rivate Guo dlaaat S207 ‘Depart (Gay Prvate Car aieage [Gay Private oom Depart Bere Tay Private Cartieaae Daily Private Car Neng ‘32m iy Private Car Wieaae: ay Pavate Car Wieage eas Depart ‘Bete [DaiyPrvate Carwieage S00 (Daly Pivate Car wioa aa Depart Arve [Day Poa Car thioage [Daiy Prvate Car ioa —o 83 ars Tatar 5 Tota S030 0575 la Tatar Is Tous la Tatar 5. Total la Tor 5 Tota, [aes Tota ine Dy 737A O75 ri Diy Private Ca eage [Baiy Private Car Mieage Eo Foim CNTR 003 Reimbursernent of Travel and Other Expenses Incured in he Discharge of Offiat Duy Feu Sct las ews sly 2015 [NC Deponment af Pudte Séfely, Division of Administraon ena Execahve, Debt NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY \ REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Mf) = and ore supparig doouments Ws or, 20S" einer Reimbursement fr approved taining expenses must be submited to OSCT. Divsion/Secton| = ng Hours Wromioy Pood by iis Request (fon JB00.AM 76 000M spans” 2816 oe aerate a0] Tate tT zfs 2Tt spefolo) t EE Tala Expense [a8] — : (0.12.95 Toes Aaranes “| Tat bve(ow) [Faro] econ the acto ie of departure and ava in blocks indicated, nm 091 Ah Commission Spend «31 = 300 TRAVEL (Show each Gy vod Tao i aval pense Explanation SUBSISTENC Stale | OutOFStae TRANSPORTATION TnSiale | OuOTSiate 1090 230 0.575 i fa Tota 350 530 7030 2130 oa [Daiy Private Gar Micage Was ‘Arve Day Private la Tor is Total e030 0.575 inl 0a 70 0.30 mi 3575 im ‘GRAND TOTALS @ = BHO ]s. Tota 3 Si 00 fats Tora ae Tipe of Subsistence: State (1) moe of rave: 8. Brakes $830 P-reatecar = Otrer rai bus, tae parking tong As R= RonalCar tuner Dinner NOTE: Day oar susistence = oi” EREGEED T 29 9p, | OCT 13 2015 Diner $21 HHowsing oom) _§ 79.50 Form CNTR 003 Reimbursement of Travel and Other Expenses incurred in he Discharge of Ocal Duty Form Sbuct aac uy 2018 NC Deparment of Pubic Safe, Division of Administration REC'D OCT 05 2015NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY) REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Erecubive Debt | J i 1 uBus INSTRUCTIONS TO CLANANT Subm ave evgral ie General accountng AIach al pcessry gia triton appovs excess egsvaton‘odgng. and ott-saleauney wave Retain ove) con You! esos, Corel amour ‘set mony and notte than 30 days shar moet mers. Prepate nr or ye Payoos Work Phone Nawiber __ 610.733.3 Fava ar [Bvasn/Secton Law Enforcement Divison / Sate Highway Pa 5 arabe supporing Saker os aug my ae sdeener fale Flea Reimbursement for approved taining expenses must be submited to OS0T, |2001 Stout st Tite sia Troop 4 oer Raeg (iy, Site. Zp) falegn, NC. 27601 ‘Gar tone poney TAR OT INoval Working Hours ramay ase JPe6d Covered by tae Request (romfo} Bes e305 (Supersaot Telophene ‘000 ‘002 0003 ‘0008 O05. 3007 [a0 “otal Expense | $62.90 Less Advance Tot. Due (Owe) mmission Stipend xSt5 TRAVEL Shon each 215 Depa ‘itive [Daly Prato Carttieage Do Priva Car tien 030 _@ 030 [Day Prva Gar ieage: 0.576 TOTS Depa [Diy Private Ca [Diy Private Car taieage 0575 | | as} \\ vised V Record the actual me of departure and arrival in blocks Tse 73 Bo rors = SUBSISTENCE slcated Char Tava ‘Gut Sate 1] —Expianaton lz Toa Total fs Total ais TouaMise Ep] —— Type ol Subsistence: State | Pee «OYA BED paucaies cae Resanaica ey 6 bee SEP 11 25 onaem "Piece encanto | 0.dew bane | l _ Aonewsng Room $7030 | Form NTR 003 Reimbursement of Tr Foun Since last revised uly 2015 NC Department of Public Safety, Orns ravel and Other Expenses Incured inthe Discharge of Offa Duly RECD AUG 31 2015iar Travel Expenses Explanation [amount SUBSISTENCE insite | Ow OTS oe) TRANSPORTATION. nSaie | OA OTSaIE TRAVEL ahow cach oy wa) Fes To. a TOTALS BROUGHT FORWARD, Depa Barve Diy Prvate Carag IGaiy Private Car Mucage Depart ‘Arie (Bay Prvate Car Mieage [Diy Private Car veeage 575i [Oaiy Private Car tiieage: [Daly Private Carton 230 © o 575 mal eee 7 (Daly Private Car Heng (Daly Private Car Mieage 30m 2.575 im Depart (Day Prat Careage" [Day Private Car Mveage 0.575 im ‘Artie [Daly Pome Car wieane [Day Prvate Carmi Depart ‘Arve [ay Puvate Cari [Day Prvte Car wea a ‘Ave ay Private Car Private Car Mies Ia Toa [sTota Tapa ‘Artie Prvale Ca ieage e000 Private Cor Mioage Depa ‘Artie ay Privat Carl rival Car Re Tapa itive ay Privat Car Nlboge ly Pave Car Mie Sega ‘aire ay Paiva Car aly Pavate Cat [a Toa [stow faa Tow Wee B G03 0575 im) GRAND TOTALS = o 3. z e. z & - = a 3. 2. a SD Form CNTR 003 Reimbursement of Travel and Other Expenses Incured inthe Discharge of Ocal Duty Form Stucure last evsed July 2015 INC Deparimertof Publ Safty, Diasion of Adminstration pecans eitS Ce ausIS 7 W2~/6 wort CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY [LW Zus fac of necssuy ong cats and fe sipparngaoeave fo ef neu ay per ry. escount ana canter, P51 INSTRUCTIONS TO CLAMANT. Suorn one cra Gerral Acrontng ston sport ol excess reson 3g ad ek slater tavel/ Ratan ane) pyr you eet, Compl abun, om tment ane attr han 88 daye ster mann ence. Prepare ni yoe [Payee's Work Phone Number embursement for approve training expanses must be submited to O80" senses 7 ~~ Wi sw Enrcomont Division State hi Te i Ranber TROOPER Flesh, $1 Tomes Parca Covered by ts Rees TaN 62070 to 627.16 FROST oT zinle Tate) WG 733-381 ‘Buparvisor Toephane F moped ‘008 0009 Taal Expenae Love Advance Tot Due (Owe) = = Jon Yale Ofer Tara Expianatn Coal Ash Commission tend # Days ws TRAVEL (Show each oy vale sas} Da Arges [Daly Prkate Cor era [Bay Peta Car nr 256 oft [Daly Pte Car ileage [Daiy Pavel 3 5 Tovar 70307 Tar 33 7090 1870 [Dany inate or Weogs 0s Ba75 in Tr 37 fais Tas SS GRanoroTALs | - Tipe ot Subsistence: State is) od of travel 8 Braves 3820 [P-Prvte Cor" 'O Otol bs. tn. pamingtees ASA «Re Renal cer tus st0s0 B-Dimer $1670 | NOTE: Datytota er sbestece Howes Room) $5730 note exseedavhorzd aroun 8 Brava $820 ° | Fore Sictue lst revised July 2015. INC Depenmant a Puc Safety, Divstn of AntratonThera pores lanaton | AmoutT SORSSTENCE Site | OuDESaE T1370 330 ANSPORTATION Site | OutOrSis TRAVEL isu each oy vated a ‘o TALS BROUGHT FORWARD. Es z Dar 75 = = oi De Ben Daly Prvate Car tieape: WALUET apa tee ay Priva Cart 730 Day Prva Car 575 FUUE [Bay Private Car Rong: [Dat Private Car wteage: WALT [Gay Private Car Reape Dany Private Car Mileage: "WALUE! iy Pte Cor aaa Daily Private Car ieape Tata 75 im Dear Arve [iy Prvaie Carmien 030 [paayPrvateCartaiage D375 i TALE at Ae ‘aiy Pre Car mage Daiy Private Car eoge: ALE! apa Ave [ay Private Cara Daily Private Cartabeage PAE [ay Private Carouge [Day Private Carn BALE ‘ve Private Car GE iy Private Car Mioage WAU! Bet aly Private CaT ew ty Private Car hea WALLET Rate ay Prvaie Car aeage [Day Private Co Mivago Tl 2575 ml le-Toar 5 Tovar lads Toute 050mm 2575 im ‘GRAND TOTALS Sf =lo)-[o]at=|=|-[=]aflo]-[=]]elol-[al3f tole THEO Fem CNTR 003 Rembursemene of Travel and Other Expenses Incured nthe Discharge of Ota Duty Form Stuctze last revise uy 2015, NE Department of Pubic Salty, OMSion of AdminstrationSIs- 77 Pa [Dm Priate Cos teage @ 0.575 ini BED S20 Depa Wi [Day Private Car lenge [Dany Private Cor tieage 19 1870 2575 rm GRAND TOTALS Bee sam Type! Subsistence: Site Ps Prater O= Ober al, vs te paring ees AAR et Car S109 Form CNTR 003 Reimbursement of Travel an Other Expenses incred inthe Qucharye of OFfial Oy Fm Strctue lat revises Jy 2018 Ne Department f Puble Safty Divison of Administration‘ihr Travel Expenses Exgianaion | Amour ‘SUBSISTENCE Site | Ox OTS 300 300 TRANSPORTATION eSiate | LOTS "TRAVEL show each Sy vated Fron i Da 33078 = = Depa ioe rie Car Daly Prat Car Dagar Bee [Diy Preaie Ca Mnage: [Day Private Car Ni Depart ee [Daly Private Cortaeaoe: Daly Private Cor Mica Depa (Day Prvale Cor aay: (Say Privale Car Maea 307A iz Oa ‘Aa [Bay Private Cartnaage: [Ds Private Cor Rioage: 30a a ‘Ate ay Prvale Car Daly Prvate Car Mies 575i Depart Five Day Private Cre Daly Prva Carvi D575 Dana Bete [Gay Private Care [Dat Private CorMieage. Rae (Gay Prvaie Carnteage @ 0mm Prvate Car Mileage ive [Say Private CarNeager [aay Private Car nteage: Arve Poste Car Private Car Mil fz iy Private Car [Daly Private Car win la Tar [5 Toit fats Tom 730i 575m GRAND TOTALS To me Form CNTR 003 Reimbursement of Travel and Cer Expenses incred inthe Discharge of Otflal uty Ferm Suture lst revised Jy 2015 NE Deparment of Puli Sally, Dion of Admiitaioni REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED Zz INTHE DISCHARGE OF OFFICIAL DUTY L4IIUZ OS SScIATaAnT” Suomt ore signa’ to Genera Aospuning Afach all necessary ongral recipi and one sipporing GoovTerta var rola ey por Gercss registaton, da, ancauto-latetcauriy travel. Rea ore) copy f! you ecards. Compete aU. compar, accourt, nd anters Fa3 sed notte tnan 30 days at monn ands Prpace nto yp jor Prove Number MMMM ————|—_eimbursomont or approved raining expenses must be submited to 0807, > - ro rober TROOPER Raleigh [Romal Workng Hours amo) Covered by tvs Request (amor a a7 4.16.16 to 41746 480 Ile ae) | uperesor Telephone A) 0061 002, am z 2tit Total Expense | Dow Tot. Due (Owe) [S eG fi ipsa sucstpesnatsme stihl nnrecsnean, — 46/0 TRAVEL (Show each Gly vated] [TRANSPORTATION SUBSISTENCE ‘Ghar aval Expenses From To [Site | Out ors TeSaie | CutOrSute | Explanation | Anount [Daly Private Cav Mieane a7 Depart ‘Ar [Bay Pri Dei Prvete Cortes [Daty Private Car ieage 0.30 Daily Presto Ca Mieage 0575 mi la Toma Tota GRAND TOTALS Sa as Tova SE | of Subratence in Sate (1) oof rave 8 Brea 3330 P-Prte Car tanh sro 8 H-Howang (Room) $6730 |nottoescend athoized moun | S199¥ N39 Ht 8 Breakiast . ° i} “H Housing (oo 1m CNTR 009 Reimbursement of Travel and Other Expenses Incurred in he Discharge of Oficial Duty Form Structure last revised July 2015 INC Department of Pubic Safety, Orvsion of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY SvcosSlan Prdecr REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES'INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. (AUIS Shien apposal of scase epee locgng, Anda ksatceeey aut Ratan one (3) e076 your eeu out roy and ot ater than 30 dye afer month ends. Preere in ope | ya) fas Porc Wok eibursent or aproved Ving epee mite ured to O50 IBmarsecbor Law Enorcement Ovsion ra State Kighway Patt Normal Werking Hours amy Covered by ths Raquel (rome 4116 10 4416 06 - E aie Z; [Sonervcor Teepnone Down Bye Less Advans Tot Due (Owe) Coal Ash Com PieTanenae | Da ‘Ou OSia spinal ‘Amu Seger {_—— “are (Day Pave a2 Depart any Private Car Menge Daly Private Cae ce S27 1870 [Dia Private Car Mma [Day Frvate Cor winage: lols a7 sta fs Tors Mae @ 057: RAND TOTALS () Mode o 8 breasts S030 [p-Prtecar = Oter tus ee pateng lees AZAR Rerfal Cat pare) sso D- Diner $1679 wore: daiy wa Rhos $073 |rottoexceod aut ouot State fron stat Foim CNTR 003 Reimbursement of Travel and Other Expenses tncurd in the Discharge of Offi Duy Form Stuur last revaed Jy 2015 INC Departmest of Pe Safety, Division of AdTRAVEL phon each Oty waned) TRANSPORTATION SURSISTENCE TnSisee | OutofSiae |Z] Site 11370 From To Tae Ait Day Private Cor Mies [Daiy Private Car Moa HAUT Depa Daly Private Car tmeage [Daly Private Car Wenge: a Depa ‘Arve [Day Private Cartage Daly Prvate Car Mileage ‘VALUET Depa Bee [Day Prvie Car tioape: ay Private Car Mia WAGE! Deg ay Prvale Car Maas Prvale Car Wet WATE Depa roy aly Pro Car aa nly Private Car Wieage ALUET Depa tive ay Private Car tieage aly Private Gar Mieage. FALE! Depart Bere [Day Private Car Wieaae: [Dajy Prvate Car Nieage: SURLUET 3| f= l>)-lo[]=ol-[=[el=lek let 3 el lela]=|=|-l]a|=fol- lo} Aue [Gay Pave Car eae [Daly Povate Car Wie ARLE” ‘spac Tie Daily Private Car iaage (Daly Private Gar tte ‘WALLET Depart eve [Day Private Cartteage: [Dan Private Car tieage HALE Depart Bete [Daly Private Car Minaya: ‘O50 [Dat Prvate Car Mileage. 0575 ml GRAND TOTALS oT lel folsl=(>/-[>14]=oleloI ie = z > > ° 2. > z 3 z . a Form CNTR 003 Reimbursement of Travel and Other Expenses Incurred in the Discharge of Oficial Duy Form Stuctre ist revised ly 2015 INC Department of Pubic Sate, Dvision of Adminstration ‘Ou OFSaE ‘Ghar Vavel By ia Toa [5 Towa iis Tots ae ‘nourIneetroniy and not istertan 30 daye ater man nae Prose lol exeeerepeatonlnspng. and ovo statncouny vow Ratan one (1) ean Your ecares NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. Gpetabis Potesbr 141 30S oer apparng daconante ots om novaea Hy wer [Payee's Work Prone Number 910-73 Reimbursement for approved traning expanses must be submited to OSD", - —* ‘Bwlen/Seston |Law Enforcement Bvision (State Highway Patol EPO Te Taber Sista Trooper Ri 9h Normal Workeg Howe (ono) F MAP. ar! 9 by ths Request (Fone) 6 32516 EXP 2324 perwar Toone fh Toy wal eats sta trata Tats tet stapeptert | Tststat t t C =e stat t t | = - rt 30 526 “john Tot. Due (Owe) [§——— 37.50 . . 4 ji2live _ ocord the actual tine of departure and eral in bocksindested Coal Ash Conmisson Sper TAAVEL Gh each oy aE) Prva Cat Niosge ay Prva Ca "TRANSFORTATION inSiate | CuOrSiate SUBSISTENCE 1 TSiae | Ow OTSaie ‘Onar Tae Explanation 5 Total Tal @ 030 Tm ia Tot [Day Private Car ticope. @ 0575 im Is Tota GRAND TOTALS Tat — iad Toa Mae Ea Type ol Suprise hse 8 Breaks 30 ‘0 Ohara bus, a pakingfecs—AZAr R= Ronis Car tuner sto Diner $1070 |NoTE: Oat ttc etsitene Ho rovsnp (Réom $470 (ratte exceed auoreed aman, onto Ste for stg 0: oa ost | | | Fo Form Stuctre last vised oul NC Department of Pubie Sale. CONTR 008 Reinbucsement of Travel and Other Expenses Incure inthe Discharge of Oficial Duty |Des? NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY ete Rekeden REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCU = IN THE DISCHARGE OF OFFICIAL DUTY XU ae aes™ | TOvneloniSacton Low Enforcement Division (State Highway Patra EPD STATE ing Hrs oe Farid Cevored by ts Request (Toma) 11610 16 tale see wate } SREP REE ee eee t : “4 = a Cry int — T | $ t a Prt Lc F.. a a J fecoverome) TE] / gle aco shactul ie of dene and attali cks indica ‘mmission Stipend $0.00 Arve (Daly Private Co Mage Day Private Car Mieage aay Privat Tbe TRAND TOTALS | mse ot reve TEANSPORTY Gu OSs 2 RECEIVED _ oar Tra Epiarston 7540 as Tora nice Ea] Form CNTR 003 Reimbursement of Travel and Ot Form Structure last revised July 2015 [NC Department of Pubic Safety, Divsion of Ad“Gihar Tavel Expenee — Expenaton | Anouti ‘SUBSISTENCE TSiae | GuLOtSae 10.40 0, ——TRaNPORTATION inSaie | Oucorsiae [7 TRAVEL how each Gy vaed J — com To Te Depa [Gay Private Car Heap [Day Prvate Car Depa are [Bay Private Car teage: [Dn Private Car Mieage: Capa ‘ave Day Private Car ateage: Dat Pavate Car mieage: Bate [Dany pve Gar wiraage eam [Daly Prvate Gar Mieage: [Gay Psvate Car tlieage [Day Fete Car tieoge: 3 Ba [Baty Peat Car veage: [Baty Prac Gar Mieage: 3 leTour 5 Toa Depa Aatve iy Prvale Ca Ba Dany Prvate Cari c Daa [Bay Private Car eage: [Daiy Prva Cartage. 3 [Bay Private Car Mieaga: Em [Day Prvate Carne age: T Is Totar Baise [Diy Prva Car Mage @ 0.30 [bay Prnate Car ttieage D575 im Danae eT ii oH Day Private Car hea os le Tora [Diy Prat Car han fo stot rz 3 Depa [arte (Day Frat Car eae [Baiy Pruate Car Maesce 5 Teal fas Toa ie Ea Tm @0575 Im ‘GRAND TOTATS Form CNTR 003 Remmbursement of Travel are Otne Expenses incu a the Discharge of Oficial uty Form Stucive iat revised July 2015 INC Department of Pubic Safety vision of Adinsraton5} NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED ——— IN THE DISCHARGE OF OFFICIAL DUTY, IAN b3 6s tng. Ato a cessery opal recaps an her suppoing doouTerts tos om, netdng Sy por frocode Complete arountEorpany, account. a centr tele Pe 3 INSTRUCTIONS TOCLAWANT Suammore orga G lander approva?o exoaet reesvaion dpe ar ouctatleounty Wael Asta one (copy [best mently ad not ter than 39 aye anermoreh ends Prepere mini or 9p ve Number Relmbursoment for approved STATE TROOPER Normal Warking aur (Fano) TA Dan} 0 L/é or f sap 7 - oae Lor tsys tet + 2008 stat Se 08 state “0005, 5/3 t t = 335 - 007 a (a0 Z t Tatoos pT Teaace a ne Tebow) [EZR ¥ Coal Ash Commssion Spend Days 515 $0.00 TRAVEL ‘Cihar Taal Bg janation ‘SUBSISTENCE inSate | Ou-OFSble TRANSPORTATION inSiale | OutOFState Day 3476 Depart Arive [aly Prva e086 31670 Ba Daily Piva 3515 20 Depart 70:90 Ave cl 7870 @ 030 map Baas Praaie Ca Day Private, 3376 Depart 730 [Baty Pate Car ege Taal F Toa aay Prat Car Mage ©3575 mF 5 Tote SHANG ToTALS Fea rae aT aE 5 1 pest Su | 1) Mode of Travel: | Outof State or in-state or out-of-state raved oo RECEIVED Form CNTR 003 Reimbursement of Travel and Other Expenses Incurred in the Discharge of Oficial Duty Form Stricture last rev'sed July 2015 . No Department of Puble Safety, Divison f Adminstration MAR 15 2016 Nc DPS Accounting‘SUBSISTENCE Teste | OuOr Sate 10540 KG} TRANSPORTATION nState | On OFSaie ove ay vad] To. z = = Depart Daly Private Car Mieage: @_030_ fa [Daiy Prvatage WALUET Depart Bate [Day Private Gar ieage Dally Private HALE Dap ‘Atv Daily Povate Car tieage [Day Private ‘ BALLET Depart {elle Sf=lel-eSe ei aitve —<— Daly Private Car Weage: 030 [Day Privat 575m WALUEL Depart Aste Day Private Car tleage Daily Private Car Mieoge: VALET Depart 030ml] F 0575 mil ‘rive [Gary Private Car nwieage C30 H [Dally Private Car hileage @ 0575 Imil P WALLEL Depart artve [Day Private Car Meage [Dany Prva WALUET ‘Depart Atv Daly Private Car Nieage ea Ta Daiy Private 0.575 mi WALUE! Depart Day Private Car Mage 730 Day Pray 575 in 7 WALUET Depart arte [Baty Prvaie Car Teage Daly Privat, VALUE! ‘Depart arrive [Bay Private Car witeage 0a Daly Prva @ O575 il 7] VALUE” a z o = ©. z a = 3 ? a = Bere [Day Private Car Meage: Oma le Totar Daily Private Car Mieage (@ 0575 oil [5 Total fads TOMTTIE E GRAND TOTALS Form CNTR 003 Reimbursement of Travel ard Other Expenses incured inthe Discharge of Offi Du Fm Structure last revised uy 2015 INC Department of Pubic Safty, Disin of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED eerie IN THE DISCHARGE OF OFFICIAL DUTY 4 aes” STRUCTION TO CLARNNT fami eeigia Gavan Nav aloreioy opal eeopmardo approval of excess registration, dg, rid over satleunty vars. Rel one (copy er yer recor. Complete Smet company, ont 274 nt ator than 30 days ater orth oe inink ore ayee's Work Phone Number (@19) 735.387 Reimbursement fr approved taining expenses must be submited to OSD. (ivklor'Section Law Ent yay Patra | state Trooper | — orca lstar-tipm 2015121420 Ue rhs ogo en 2 saree LUNE no. suouns company account Tare To is t t Seer 1 787 Less Advance JAN 05 2016 12 /2e/is— Tet. ue (Owe) [¥ 74870] Rocord the actual time of departure and arrival in blocks indicated. ‘Coal Ash Commision Stipend # Days. sts TRAVEL Show each cy wed) TRANSPORTATION ——T SUSSSTENCE, her Travel pense Da insist | -OutOFSiare insite [Ou Boianaton | -Aroutt ari7 : rt 3 aie 1870 Daiy Pris carmieage Toa (Daly Privy Tota Baars 3:30 ‘Depart 7030 Aa [Daty Private Car Wieape la Total [5 Total o 18.70) Sx mr 0575 mil F a RECEIVED | ees al DEC 30 2015 unis Payal Foim CNTR 03 Reimbursement of Travel and Other Expenses incured inthe Decharge of Oficial Duty Fon Structure asl revised Jay 2015 INC Department of Pushe Stary, Division of AdminstrationSiher Travel Expianaton ‘SUBSISTENCE Stale [Our Sate 105.40 30 TRANSPORTATION — in-state | Ow OFSiaie TRAVEL [stow each Gly vied) From To i = = Tara ‘Depart ‘Ave Bay Prva eae Daly Private Car teage: Depart iy Prvaie Car Mileage: ay Private Car tleage Depa Alte iy Private Car Maa ED aly Private Car Mileage le Tovar 5 Tota Depart Aire ay Private Car bape Private Gar Mie aa Arve. Day Private Car Me (Daly Private Car May 3 Depa Arve. [Dany Private Car espe Daly Prvate Car Miea le l-le[SI=lel-lel a Depart ‘Arte Daily Private Car Wage: @ 0m aly Private Car Meat 7 Fate iy Private Car Mioage iy Private Car Mea 3 Depart ‘Rite. [Daay Private Car meage Daly Prvato Car Mieage io a 2 Depart L ‘Arve D w la Tovar Private Car Wage: eo, Private Gar Mle T Dai 5 Total am Aatve. aly Prvaie Ca Wi aly Private Car Nie 2 039 in Depa ‘Arve Daily Private Car tieage: [Dany Prvete Car Mieage la Tatar 5 Tota lads Total ee By S030 Tail 0.575 7m] GRAND TOTALS Tae Form CNTR 003 Reimbueement of Travel and Other Expenses Incurred in the Discharge of Otfial Duty Form Sucre last revsed Jy 2015 NC Deparment of Pubte Safety, Division of Adminstrationnee) NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY DPS REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED meena nest IN-THE DISCHARGE OF OFFICIAL DUTY LAiGses” [Payee's Work Phone Number ‘Rembursement fr approved nouns must be submited to OSDT. Lav Enforcement Division / State Highany Patrol EPO. Tie Naber STATE TROOPER _ Nore Working Hours (romo} Ferod Covered by tus Request fron aC ow > JAN TT Biv te Tot. Ove (Owe) coinertalineténmuasndaraliniictsniets — RECEIVED nSue | Ovorsae TE Tot any Prime —_ [Daly Pritts cari [Bea Bova [ay Prive Gor Dat Prvate C eee ime talease @ 0375 ml GRAND TOTALS D- Dimer $1870 er Expenses Incurted inthe Discharge of Oficial Duty Form NTR 003 Reims NC Department of Public Safety. Division of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Hs err cro carat Gane Kcarig. Ala ances ces eos cot nsonr cosorenao hs wn rasa LRN on gra ans cuecccrnarty tol Res en (copy cae Compas aot, pany, roan te cote ees Fe a Fer an 30 ays ae orn ends, Prpare nik or po Se re Nebo, — (RIMINI) reiouraner or apron traning expenses mtb ste 19 0507 “isk. Medal Wal, Last) sr nee Lawe State Highway Patrol EPO sf jamber STATE TROOPER [Raiegh St arma Working Hours (ORO) Paviod Covered by iis Request (roma) _ fare ro 5 rae a TB escent coty 11302015, Te lolalalalo| lalololofa| Taal expense [5 A ain Sey Less Advance ec 162915 ala care ost obs Coal Ash Commission Stpend Days «S18 $0.00 TRAVEL (Show each Gly wate) rom sigue T Bay [Out OF Site 112378 Depart I Arve (aly Prva [Daly Private Car hieage 15 Depart Arve Daly erate [Daiy Private Car Wleaoe ne .. 7 INTHE DSCHARGE OF oFFicu DUTY | (41 o3e- a pc pam aeY coaches stereo isis ir apirbanerisaamt aie a Las) Pier/Sacion T Js tvrcontnovsion st vgiy eal Ee rie state Trooper IRategn Posiod Cover by tis Raquel (Ramey 1 e106 envie_ 100 W. Blount Si. cay, Siete. Zp) ermal Working Hours ery aeign No 27603 beri ipione Ine per bor epouptr owemgh reve wat era voice Day forey “SY sare ah 3 —_ i ae eee { lar ‘0003, ss Sisfet7ijayt | er | a state 1 [toe —T# at ‘Ste z | oF : : B08 5 1+ 0008, I x i Tolal Expense Jow ot. Due (Owe) o/alle Aacord he aca ine of depose and arvalin Wack indie. aa Ash Comnisson Spend Days: _ $15 = 30.00 | TERRE ion sak oS AREA AON —]——soe sre one Tae Ba Fra fe irae | aurea | — ieee Span oa oy 7 ee a “tas | n — a = Se + 3}}— et —t barred $ Bari Cr wage oT TF fae a9 run eo Coal tat —t | ie S = — | ban Re Cormieape ———g- 059 mal > {roar is ca Sas al a Sa a —— S oa] * +} —a0| —1 mae $ sts— it —T arene Coreape gor + o t— rear arpa corns ——@- Dre mF ats — ta ween $e] fa tar (apron nso raw Dba | eee ite | RECEIVED Mtg oan) 8738 | yur 13 208 Cte sao ting D-Dimner $2199 wc DPS Ac 4 Haun (Roont_$ 7939 Foxm CNTR 003 Reimbursemant of Travel snd Other Expenses Incurred inthe Discharge of Oficial Duty Form Stucke ast even July 2073 INC Department ot Puble Safty, Omsionof AdministrationSUBSISTENCE TrSate — [Out OTSe Cr aa 390 Ciher Tae Expenses TRANSPORTATION a Expianaton | Amoual iSuie | On OTS. — TRAVEL (eho Sach oy wate Fre To 3 = a De iW ay Prato [ay Privat aa Depart Aree Day Private Car Weaga: Daly Private Gao are Depart Day Private Cor reap: 030 im Dany Private ©0575 ini 575 im 2575 im) ay Prvate Car BS 030 ma ay Private Car Mle O75 Im 7A Depa Bet aly Privaie Cor Wieage [Day Private we. ‘Depa Daly Private Car Mioage [Day Private Car Mage: Bore ‘Depa Day Private Car age [Osi Private Gy B20. Depart eve [Day Private Car henge: Daily Private Car Manage Beis Depart Daly Private Car tieage Day Private ea ‘Depa ve Daly Private CarMieage: [Day Private Cor Mieoge aoa Depae Ave Daly Private Caren Daily Private Car Mieage. Baan Depa Ave [Day Private Car Micoge [Daly Prvale Car Mivage: lel lelal=[el-=[=}=lel- I slolrfel Steal lalSflsl-lelel toll is Foal [aes Toma ee Ea OH 575 rm GRAND TOTALS Ta om CNTR 003 Reimou'sement of Travel and Olter Expenses Incured inthe Discharge of Ofc Duty Form Structure lst revised July 2015. NC Deparment of Pubic Sstety, Con of AdminstationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 141 Waes” TONS TO CLAWANT “Subonlonecngnal a Gress Arsomtng. tach recstararghalecepls ad cher sopping Socuent os fo, cluding any ral tenors epson, adgng, anv octtateesuny rave Reta ne) copy tar you rors Corpse amu. eomeary.cccoun and ceri fas. Fle at [Payeos Wor Phone Number a1 733387 Reimbursement fr approved raining expenses must be submited to OSD. je Wa Laeh |Dvasron'Secton [sw Envorcement Owision | State Highway Patrol _ Tie hNaniber 200 N Blount Trooper leigh Ze) Tear Waning Hers (emoy ]Prried Covered by Ma-tip | Marsig aer2016 Qo. ZIT ITAL aperweor Telephone rar erste Ct rt Taal expense [SE 6080 Nea ieee 5/4 /1y Fam To T[—“siae | Qutorsiae 12] —Siae | Ou Saie | Expansion [Ameo to. 5 = mG os ml P| H 3 575m] F Fo Daly Private Car We CoD ALP co Day Prvate Car we 0575 imp For] Za z [Poepar Rive (Dany Prvate Ca _— Daily Private Car tieage @ 0575 7m RCE is Tota lets Tomine Eat — = ED (Gy Type a Subestonce in Sate “RECEIVED” remmtce | Etta sayuraname | May 17 Hd GL AYHSIOZ] seioccon S38 feces ue D190Y N39 NIG.O3Y) o-Pee — AL Antigo Form CNTR 003 Resnbursement of Travel and Other Expensés Incured inthe Discharge of Official Duty Form Stucture lst revises uy 2075 NC Depariient of Pubic Safety, Division of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Gye Bribe REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED. eee INTHE DISCHARGE OF OFFICIAL DUTY 13S" TNSTRUGTIONS TO CLANANT “Simone ongnalio Genera Acannire_Ataah a pecssayoighal/eoeris and ale suppcing documento ts fom, ncueg ay pee sian septowt of exes register edpAg, and ott wnecoly vava Reta Oe eo You Yeas Complete amour company, accunl, andeve ts. Fes [Goermoniny 208 otter tan 30 daye sen ends Prepare in D8 "ayee’s Work Phone Nomber 919 739.3674 [Reimbursement for approved training expenses must be submited to OSOT. i testy Diision Secon Lo Enforcoment Division / State Highway Pato Tie [Ronee _ Trooper ategn (Gy, Sate, Zp) Normal Working Hours (ram) Prod Covered by tis Reguest WonTa) [Raegh NC 27601, riatip si1a016 312172016 (ier ie EAA HS REG GET ae SAT RT Ta ey aT TOT TTT bigts nese nd Renters maaedin ne semce ate Soe hae ety ‘ane hve pron rr aor orowmgavlans3 uso petra ee bm £92) 233-3871 (sinewaar tom ‘0001 = _ stsf2t7iiT T wor sae] TOs Ts} tab retate: 05 TF stapatrpart oot —T$ share — a a[s z | 7 $008 —t f 207 =i —} —— t LT paAIDE; S068 i j (eoainecs [oa] PRISM Som You Bue Owe) [E7“FE7E] 4/ezd ie ‘acorn stale of donarure and aval in blocks indicated, Con Aan Commission Spend fay Yes = 000 c Tae Ge aaa TRANSPORTATION REST [one Tinea oi Tins | On ocSine [7 —inSie | On dvSae| eames fame ee & e _ tier = ts Tos a 3 ops 187 air tats Cornenne eos * fra et va @Usr5 ml Faas Toa Sate = osm an = * Epes [ates ~ 3 of $= 1870 Daly Pat Caioage Som male £ Ta ai Pg a7 mal F fore raat —— = z tee 2 os 1670 Sai ae Came oar = a Prvale Car Mieaoe @ 05% ml aS a GAOT See Tapes wee te foeate ge30 ovotsute foes rout vor tere $920 tan Ses 0: Oemer 3a30 Hineverg Reon) 5.7340 | Form CNTR 003 Reimbursement of Travel and Other Expenses Incured inthe Discharge cf Oficial Duty Form Stucture ist revised uly 20° INC Department of Pu Safely, Dirsion of Adrnitation“SUBSISTENCE, TS [Ou Sr State i540 B[s 830 TRAVEL (eho wach Gy VTE) From _To. TOTALS GROUGHT FORWARD. "TRANSPORTATION in Sise | OROFSSTE —iher Tal Bg Os z SRT Depart —aeve Daiyprvaie Cs Diy Private Car Micage D575 im ve Daly Pruaie Car hweage——@_0 307ml Day Privat @ 0575 mi Oe [Daly Prvate Car Mieage——@ 0.20 [Daly Prvate CarMicage 0575 Im Depa = Barve ay Private Car Miaage— rl “0575 imi Day Prate Careage Dai Private Car Wheage Ta 0.575 Capa Rave [Day Private Car eage: r= BSaceiega 0575 Depa ‘re [Daly Private Car Mea [Dewy Private Carica are iy Pris Car Wa iy Private Car Mie Dasa [Daly Prvaie Car lease: @_ 0.30 imi [Daly Private Cau Depa ave ‘Day Prater Car Maa om [Day Prvate Ce bars Depart Arve [Dany Prive Car age [only Private Ce ere (Gay Pie Cor iene ‘S05 [Daly Private Car taeage 3.75 im ‘GRAND TOTALS la Tora — [5 Towa eds Total se Ex Tae Form CNTR 003 Reimbursement of Travel and Cher Expenses Incued in th Discharge of Offa Duty Form Struct ist evised July 2015 2 NC Department of Publ Safely, Division of Asminstation eeol a NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED xed INTHE DISCHARGE OF OFFICIAL DUTY (AN 30S TNSTRUGHONS TQ CLANANT” Saami one ctaralw Gereal Accounting, Atach al necessary ovaralrecapls and oie’ sappotg docu ofan. neva tan approval Ol excess register, xn abd Ou-olsateicouty Yaw, Rela ne (1 copy Yow less Camo snout copay, SECT, 3 ‘vont nds. Poparein nko ie, net monty an nt later than 30 days Payee Work Phone Number 910 793 9871 Reimbursement for approved waning expenses must te wares IDwerSeaion fe re Teocston Name & Raber | pon Bout 5 Trooper align Chy, Sate. Zp) [Noma Waring Hors trom TPR Covered oy Wis Rogen TaTTAT Ralign NG 27501 itectip ___| "724 oese | tora, eons BS t 128-3611 TSuparvaar Telephone # EE ‘007 0002 0003 00 34.90 see Aavancs fa he Tot Due (Owe) (35850) Coal Ash Commission Stvend #Oays “sis = TRAVEL Show each oly vstea) 5 ‘Ther Travel Expenses Explanation [Amount SUBSISTENCE, TrSate | Ou OFSare TRANSPORTATION inState | OuOrSiate 22076 Dupart ‘itv Dally Prvate Car Mieage: 030 mi [Daiy Private Car Micags: 0575 mi aa Asie (Day Prvate Car Tama Dally Private Car bileage: lator 5 Tal ie Tom Tata fade Toa ee Ey [Day Private c Daly Private C = 3a (2) Type of Subsistence: in State GRAND TOTS 1) med of travel 8. Breaatst se30 |P-pmate Gar "O= Ober ro, tnd paring fees A=Ar R= RantaCar | Clune stas0 wot Sate Hor in-state or out-c-siate ravel, Breakfast 3230 tks Form CNTR 00S Reimbursement of Travel and Cther Expenses incued in the Dischare Form Stuctre last raves uy 2015 INC Department of Public Safety, Division of Adminstration NC DPS AccountingNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED _ IN THE DISCHARGE OF OFFICIAL DUTY. [411U Ses alto General Ascourtng, Alec al paessary cgi reosts and oer supporting docureris hs im ore 1) copy frou ecards, Corglte aroun company. acount 2 INSTRUCTIONS TO CEAIANT. Submit on woe appro ctexces epstaion.odghg, ad ou-ctsatoeoury vel east rently ard not ater tan 90 days ae’ mont ends, Prepare rk oF Noe EET) Relmbursamant for aperoved alning expenses must be submited to OSDT. TiaseniSecton = “sar | Taper ‘Tesetgn ne Fa aT Cae ys Re TRY Petar | [Payee's Work Phone Number aia Tata a Notount St icly, State. Zp) [Raigh NC 27601 lol — helt ole 9.122851, eQI Sle ~Wlbl wmeno | come | see . conse 3000 F ert bt ttetstal a Stet oS — ststa —— = ma + 007 2008 a 008 t Tear eee [a0 Lees Advance 1 ue Ow) Earle Record the actual time of departur (Goal Ash Commision Spend # Days, sis = $0.00 TRAVEL (Siow each oly vised) TRANSPORTATION. From o inva | 0 “Other Tava Banas Explanation — | Amount ‘SUBSISTENCE. TnSiate | OucOF Sate 330 1870 Sate Day PETE “rive (ally Private 8 (Dany Private Contes ZB | Depart [Day Private: Daily Private Car Mieage Time Depart Bite Day Private Car Moa [ay Private Car Mieage: la Towa 5 Tota Ta 230 7090 @ 0575 mi ea Baal @ 0575 mi GRAND TOTALS lac Torat 5 Tota fads Tome Bp Bipes |) ode of rave: bite ar Ota. uk pang Wes ASA ero tare ; fa. Hoearg eon pr eboe senna | outot state ein toto cr cuto-tate rel 2 an " Mtoe oon $7380 | RECEIVED oan CNTR 003 Reimbursement of Travel and Oke Expense naured i the Oschage of Of uty MAR 15 2016 Fou Sure lest evsed ly 2015 NC Department of Publ Safely. Dison of Adminstration NC DPS AccountingIGa NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 1 nat later than 30 days ater morth ends, Prepare in mk o pe Reimbursement fr approved taining expanses must [Payee's Work Phone Number 9107333 ie inal, Last) [Dwieanrsecton aw Enfer sion State Highway Pat Tite Number 200 N Blount St Trooper [Raleigh Paiod Covered by ta Reaeat oma) Jets, State, Ze Normal Waring Hours (rom) 2246. [Raeigh NC 2760 iaitp ub to OSOT. Daley 219-8261 Supeevao" Teaphone #) Exp. 292 ~ 092416 Tha PHape HT etstelet | 72 soe 5 [0002 — Ts 8-2 | 90g oor ——T$ = cons ——T$ 05 07 = Cor : T 208 Faint t I I os, Tat war 2.2 208 Total Expense blocks indicated glove Tot Due (Owe) Coal Ash Commission Stipend ] # Daye. (Ta "TRANSPORTATION. ‘SUBSISTENCE: Ole Travel Expenses ‘Ou-OtSiaie_| Explanation [Amount Tsu Tn-Siate | OuLOF Sate Oa (amet ‘Ave. lay Private [Daly Prvate Car Menge: Depart Ait Daily Private Car Mreager [Baty Private Car Mileage: Capa ‘ave Daly Private Car teage eam Tal Dally Private Car Nleage- 575 [5 Tota fats Tota ie | 7a GRAND TOTALS = Type of Subsisonce: Sate ten $1080 [Private Cor = Ober ca bus a ping Sets A=Ai R= Resi Cob b-bn NOTE: Oat oat rsusistence Huse (Room rato exceed authorized aman outor state erin state o out tate evel H Housing Roomy 6 79.50 ravel and Other Expenses Incurred inthe Dischrge of Form CNTR 003 Reimbursement of Form Stucuelak revised Joy 2015 eats RECEIVED NN Deparment of ube Sle, Ovo of Kninraten MAR 15 2016 NC DPS Accountingce petae 18 see NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY | DPS. /6-H6~(7 peimeuRSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED once IN THE DISCHARGE OF OFFICIAL DUTY rit © 36S INSTRUCTIONS TO CLAWANT” Sub one ong! Gene a! Aacontrg_Afacal rez ofc an fe suppoyaosens fos om tren opr excess regu aten,odgng, aout teouri Wore Rela ore (1) copyoryu ears Compl amour compary account fast notny ae ote than 90 aye tt monn ena Prepare irk De ] Payece Work Phone Nuriber 0107393871 Reimbursement for approved training expenses must be submited to OSOT, IDwaionsSecion ~ Law Enforcement Division / State Highwa rite Trooper TNarmal orang Hors Wom) 142018 wi7/2015 1 anot 0g 03 G00 G00: 006. 10a on08 Tata Expense ess Ava Tot. Duo (Owe) re 001 Ash Commission Sbpena #09 4515 TRAVEL ‘Oihar Towel Expenses Daly Private Car Mage [Dany Private Car niteage [x Tama 330 7030 1870 [Daly Prvate Car htleage: (Daly Prvate Car hleoge: 30 aes 3630, [Depart S_—j0390. Arve $1870. [Baiy Paste Gar Nueage. [Daly Prvate Car Nieage. a {Br Type of Subsistence: in Sate | Pp Ecemgtom S cerca || | cor ne came Su | RECEIVED || wr 1b ey - Rikon omy sce | OCT 99 mn6 | Form CNTR 003 Reimbursement of Travel and Other Expenses inoured in ihe Dischatge of Official Duty jure last revised July 2015 | nent of Puble Safety, Dison of Acminsiraion| | : | TRANSPORTATION ‘SUBSISTENCE (Other Trave Expenses iSite | Out OFS Site | OutOFSiate_| Explanation — | Ament 11370 330 TRAVEL (Show sash 8 From, waieg) To. z Bay we Depart Arve. [Day Prvate War Mtteage [Daly Private Car Mieage (@ 0575 ml a Depa Ave [Dany Private Car Rimage [Daly Private Car Mieage o Depart Bate [Day Private Care Daly Prvate Cor Mie: a C30 2375 im] ‘Rive Day Povate Car Wea [Baiy Prvate Car Mieage a aa Aitve [ay Prvaie Car Wiiage [Day Private Car ttieage 33 =| =o [>|] =] }ol>[2] 0] =fof>[ | o| ofo[>) |») ofo|>la} »| efol>[=} | wlol>]=] =] elol>lal =f ololslal wlll lal ol olotslal Depart [Day Private Car teage Dally Prvale Car Mea 7 “ee Dany Pais Carmeape ole [=lSf= lolol af=lel- lols =lol-lol at [Daiy Private Car Nhieage ror 7 2 Depa c Reve 3, (Gary Prvae Carnage C00 x (Baiy Private Car leage ir 7 2 Depa t Arte B. a [Daiy Prvaie Car eage [Daly Prvate Car mieage 2 Depart [Day Private Car Who Day Private Car thieage 7 Day Private Car Rie [Day Prvaie Car Mieage t Baive Day Prvale Car Maas. [Diy Private Car Nea la Tovar Is Toma [as Toa MSS S030 0.575 7m TET 5 Form CNTR 003 Reimbursement of Travel and Other Expenses incurred in the Discharge af Official Duy j Ferm Stuctre las revised July 2015 INC Department of Public Safety, Dision of Adminstration iGocetve Dede NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED | IN THE DISCHARGE OF OFFICIAL DUTY LAU aes | "a7alreceips and over suaporing canaries fo Ws fom, lucha ay erar INSTRUCTIONS TO CLABIANT” Gibmora ougnal General Accomirg_ Atcha nacess triton approval of excess regatta lodgng.endout ct-aatelcounty tavel. Rela cre (1) copy er your rocrds. Completa ae leas reiny and net later than 30 days ane month ends. Prepare mink o yp Reimbureoment for approved traning expons [Payee's Work Phone Number je ral Tee lOwran’Section Trooper ; od by ths Req onto (ty, State, Zp) arma Warking Fours (roma) Raleigh NC 27603, 7a.7p s2neld 12t75 ‘seperate: ol pa Toa a Wa wa Sn STB a cara san are oth PTT 19.8815 | ‘TeuneriserTeleohone #) z 1 T Tt 2} 7 fata Ta td = T stat 5 I I lk ae 70] fe[iy ime of departure inbloch indicated - 3000 TRAVEL (Show each aly walled) "TRANSFORTATION SUBSISTENCE Diher Travel Eperses : “rue | Serorsae -E[ sae | tors | —eeton | ance ae Depart ‘Arte [Baty Prvaie Cantease Daily Prvate Car tieage: 7s Depart Day Private Car Meage [Daty Private Car henge: DE75 i Depa ‘arrive [Day Prvaie Car Mieage: © _0w_mil lator [5 Tota ‘GRAND TOTALS [aes Tour ase Ey 7—_ 7H (2) Type of Subsisence: Tn Sate 8 Brosktast =o Diner sia70 Housing Room) $87.30 8 Breas (1) Mode of Travel: P-Prvele Car "= Ofer rl tus. ta parking fees ASAr R= Renal Ca {OTE: Day iat ss ret to exceed authored amourt | | - 7 Jat 201 Form CNTR 003 Reimbursement of Travel and Other Empenses Incured in the Discharge of Oficial Duy Form Svctue lat vied Juy 2018 oats Payal NC Department of Pubic Safty, Ovsion of Administration Accounts PayNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Gy ygsuaBs. Protas REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. AQUW3G5~ Reimbursement for approved taining expenses must be submited to OSDT Draon’Secton Tite " Trooper Raeigh INonmat Warkng Hours (remo) Paved Covered by sat 2ia0015 WiZ016 “ ie [Dale ion Prove Number 9107337871 carter Ths Request ama) (cty, Sie [Reign NC 2760: Une no. awount compar accouve oot 1 T ‘oz {atat Zn 003 (eo) OTT 00 0006. 0007 [one 0008 — t L I L Total Expense Less Advance Tot. Due (Owe) Record the actual time of departure and arrival in bigcks indicat Coa! Ash Commission Stipend # Days. «$15 = $0.00 a x TRAVEL Show each oye TRANSPORTATION SUOSETENG Da iz Tine TRO 350 0.90. 18.70 @ 0.30 imi : ir Te 330 0-0. 1870 Daily Private Cartes Dally Private Can THs Depart [Daiy Pratertea tonne mn 0 otal [Daiy Prvate Car mag 0.575. GRAND TOTALS saa faa Tome Fy 3730, 300 (Gy ype Subsisienze™ P-PrveteCar = Other, albus, ox, packing fees R= Rental Car uu sios D- Dine 31879 |NOTE: Oa total substence H- Howie (Rom) $6730 | oxtotsiats D-Drrer Sas | ‘1m CNTR 003 Reimbursement of Travel and Other Expenses Incurred inthe Discharge of Official Duty Form Structure ast revised July 2015, TNC Department of Publi: Safety, Division of Adminstrationwa NORTH CAROLINA DEPARTMENT OF PusLiC saFery -ExeecuttNe Debs J REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED ‘meraet oon ter IN THE DISCHARGE OF OFFICIAL DUTY. L4ulbses” INSTRUCTIONS TO GLAMANT. Submit one ovginal te General acount. Aflac acess org recaps an oe” supporing cocumari fo som sudng ay Fer “anton apr of exces giao, edging, ans ov 2 seauey aves On (1) oopy ke ou reas. Complete amet company, axcun ardent ads. Pleat lesstmonthy and nt ater han 30 eye ate month ence Prepare ink ope [Payee Wotk Phone Number __@187393671 Reinburtoment for approved raining expenses must be submitted to OS0T. cs Faia, Cas ivicrrSecion Division / State Highway Patrol CF erron Nara Erbe? 1200 N. Blow Trooper IReieigh {iy Sake Zp) Nat working Hous (romioy [Pied Coveroa by tie Raquel Foy ioigh NC 27601, Hane Somos 1/276 ‘Ge probes poh Te i abe WE SEATON HEROS TRS SAT HSIAO ae aT PTT PETITE T Ici. tmser et eonaners wed ecto hater esi hw gen ps moore see etree tps ee. ‘Biperrear Teephone #) me no. awount «: O09 z 0002) 295% 9003. < = = = 4 Trai ThelsI ‘004 0005; 0006, ‘0007 ‘008. 008 2 Teial Expense [6 45" cror-r less Advance nL, vo5%m Teed Fears VOUS /” Hv 2 205 Coal Ash Commission Stipend - * ion “hs = sone "TRAVEL [Show eneh ay wae) RANSPORTATION TneStse | OuLOrSiaie SUSSTENCE TeSaie | Ours 550 $7090 s——i870 Day Private [Bay Prva Car Manag Twas ih (Day Private Car Maes Dai Private Car wie THE Brive Daiy Private Carte Daly Prvate Car Mis 7H 70 090 0.575 = sia arom 15 Tot fags Tole Ee 0.575 GRAND TOTALS am 350 = So — maa Recene fe faunas RECEIVED | fim Auk | nov 18 295 eee 152 Form ONTR 003 Reimbursement of Tavel and Other Expenses Incurred in the Discharge of Offa Duty Form Structure las revised Juy 2015, [NC Department ef Pune Satey, Dvsion of Acminstation‘Char Travel Ex Explanation ‘Amount ‘SUBSISTENCE Teste | OurOFSiate EO ED TRANSPORTATION In-Suie | OuOFSiaie XvEL (eho each oy vised) From To. TOTALS BROUGHT FORWARD “Depart aire. [Gay Private Car Mueave [Dany Private ci THT Depart Arve [ay Priva Car Reape [Daily Private Tarts Depart Day Private Car Wenge Daly Private Car Mueage Tuts Depart Arve aly Private Car Mieage aly Private Car Mica Tits Depart Arve. aly Private Car Wibage ay Private Gy THT Depart arrive ay Private Gar Mileage iy Prva Tans ‘Arve ay Private Car MiB [Diy Private Car Noone TT Depart ‘fave [Daay Prvaie Car tengo Day Private Car Mieage Twos ‘Depart ‘Ave Day Private Car Weage: Daly Private THs at Arve. [Day Private Car ea [Baty Private Car Mier STUPIES Dapae arrive [Baiy Private Car moog @_030_Ti [Day Prvate Car wieage Tas Depart atv [Day Prvaie Cartage [Daily Prvate Car tieage: 0575 mi fof =lof>[=] »|=[of>[>]-~| =lo|>|=] =| ofo[> fal ol lol>lal of clol>|al el slola tal 730 0.575 ini ia Tor Is Tota [ads Total ice Be ‘030i 0.575 /mi ‘GRAND TOTALS > F 0. e fe A o z o > et Form GNTR 003 Reimbursement of Travel and Cther Expenses Incued in the Discharge of Oficial Duty Form Structure lst revised July 2015. INC Department of Pubic Safety, Dsion of Administrationcor NORTH CAROLINA DEPARTMENT OF PUBLICSAFETY pec. tte Ota’ | REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED / IN THE DISCHARGE OF OFFICIAL DUTY LA 2s / triton epprova of xcs raptatn, Ieestmonbuy ad aot ter than 30 days ater mah ends. Preerein i or pS Reimbursement for approved raining expenses must bo submited 19 OSD rng, ad otter rave. Retain one (1) epy fr your reeatas Conte amount, eampany, aout ance Payee Work Phone Number fe ia.) Payee's Accress (Skeet), i [tscaton Name & Nurber [200 scant St IRatigh Ky, State, Ziy Nerval Warking Hours (roma) Period Covered by tra Request (ion leigh NC 27601 tiattp 7S 12S, ‘ory ern ef arn me neva ect tegicte, nave rnp roc ova eel an 82D ‘aie ABS ‘Saperviaor Telephane#) 0006; 0008. 00 Taal expan [ETE Dem Lees Adena \ Tot Ove (Owe) [S——waz00] > ofi¢ Record tho act 3 departure and arrival in blocks indicated. Coal Ash Commission Spend 2 Days, xsis = $0.00 TRAVEL (Show each cy wate) TRANSPORTATION. = utes ‘ihe Travel Expenses Selanatien | Amount SUBSISTENCE estate] On TS ED $1096 s——270) ir-State Daly Pi Day Priva Tas ‘apart Daly Private Car eage: (Daily Prvate Car Miage T2a7" Depa ‘Ate [Day Prvate Car Meage: Meade oz 70:90 18.70 ‘©0350 0.575 ini 750 $50 0590, 8 S030 2 a ee —7 ie RECEIVED] umegem [eset JAN 07 2016 | &-tonen $10: in the Discharge of Oficial Duty Ri Ae Form CNTR 003 Reimbursement of Travel and Other Expenses incur Foim Structure last evisod July 2015, NC Department of Pubke Safety, Division of AdministrationCir Travel Explain nou ‘SUBSISTENCE estate| Our Sate T1370 RANSPORTATION — In-State | OutOF Stale “TRAVEL how each ay we) — From To TOTALS GROUGHT FORWARD. z z Tae Depart ‘Ate [Day Private Car cage: G03] Diy Prat i Tari Depart ‘Biv Dany Private [Day Private Gar Mieage: W225 Depart Ave Dany Private Car aap Daly Private Ce zon Depart Ave ay Private Ca eae aly PrvsleCarNteage: ATS Depa rive Dai Private Car hieage [Daly Prvate Cas Migsge. 125 Depart Ave [Dany Prive Cor Wbaae: Daly Private G “2S Depart ‘Arve [Day Private Car Reape [Daly Private Car Mieage ais Depart ‘ative Daly Private Gar Wieape Saal [Daly Private Gar Mieoge: T2a8 Cepar ‘Arve Daly Private Car taeage S050 Daily Private Car tleage 2A Depart ‘rive [aly Private Car Mieage" Daiy Private Tins Depart [Daly Private Car meage [Dany Private Co Ta ‘epar aie ay Private Car Meape aly Private Gar Moa 3 F=[o]-[=|S]=[o]-fo) = =|=|-lo|S]= lolol) =lollol als lolclel Tar [Tota fees Total ae Ey 030i] 0.575 /m ‘GRAND TOTALS Form CNTR 008 Reimbursement of Travel and Other Expenses incurred in the Discharge of Offical Duty Fo Struct ast revised July 2015 INC Department of Pubic Safety, Divsion of Administration anataZod joo INSTRUCTIONS TO CLARIANT” Sieme ane ongraifo Genta Asouning ARaoh al recessary aigha Tacos a region loipng, ond out of ltscauty Wave. Rela at) cop fr Yur writ apart Payocs Wok Phone Number 9197333071 ayee's AdGTess (See!) Epfctutue Desmt NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Comsiea amo —_]___Reimbursement or approved training expenses loivsioniSecion Law Enforcement Owision State Highway Pate Trooper IH G3u 1 AP Location Name & Number [Rate L 12001 Blount St cay. Site. Zp) leigh NC 27601 ermal Working Hours (Pome) aig ir20%s s22201s 008 ‘00 ‘0006; ‘Do07 0008 0008. Tot Due (Owe) [E5830 A 10-5 |S facord th actual tie of epanure an aivalin bocksinicatea, JA — Coal Ash Commission Stipend — Store Sis 200 ~_ TRAVEL [Show e50h city visited) TRANSPO! I “SUBSISTENCE ‘Other Travel expenses] tee on aae Psa | Oars | Een ea iB = = at = - El 8 fra E ss EF: Nios = f F ts —,, Depart A - Te v ave. o > Wasa | [Daiy Private Car Mileage: @ 0575 im PY For T 5 Total PAID Henossg (team) Sorat lenitemel uabattonare” cat 1g 23 eee PP RECEWED Omer sha OCY 09 205 RECD SEP 29 2015| NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY | REIMEURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 07 @3i4 TNETHUCTIONS To GANANT. Sasioworgne Genoa Acourig_ Ato) al cesar gral cep ard oh upping aoaangs i BisTom.ncuing snr ‘romapre oeaacn mgarucn basta Coeussowennny bor Ranney ir war teoee Conga aon serpy acct car as ea ICatnetiy dotlrn 30 Gye the oneness mic We. False for prone rein Drisanvsecion Law enforcement Ouison Sat Highway Patrol, rae per Trooper aah [chy San) Romar Waking Haar RORACT FaraaC vere is RETR TOATET IRseigh NC 27601 lacy 6.23-18/8128-15. hos puss ol pay AW Te Ba i BT aS TAROT TCT Ta ano HE TOT i 8 MATTE TOT \eageg spun anf owonnemesncie be arecect ne Sine Teter Sty note, Inte oan pooper over Fal andra fran wh, SSinSWietesocaysw a na noes aie ‘Gupenvaor Telephone Hy Total expense — [$0550 Less Advance \ Tot bu» Owe) [Fae] | (Goal Ash Commission Stipend oy Tis = 20 ie RTA SUBSISTENCE ara co rinse | Ow DrSae [7] Swe] Coors | —eaparsan em | a a Seat 7 N ; a eT t t Era a ol a TAT Tot 2 © = zi} Dy Pe Creag GOTH mt feta yr ase Carer v1 aa ost Besa 7 $—inss fe : ir TRSOTOTAS t $s fas Ta — Ca patsamarer Tt b Scie Se fan: omy tener Aneta eon) 30790 [tems ane © 18 BS uaa esa cer bg 209 "Senin two REECE coms [PT gg m6 Reuss eend. frase ci 08 Fen ciate nO rb Dn on De Sern aA a apes RECD SEP 14 2015jai aval Expaneee avout SUBSISTENCE — TeSiale [Ot one Sglanaion > TRAE aw ated ‘Ta “TRANSPORTATION inSiele | Ow OFS Oa $102.30 aes 5 330, Depart $70.90 Aue $79 [Say Prva Carnage 6030 [Day Prva ams ‘Depart ‘Arte Daly Private Car Mea Dai Private cas a) 30 70.90 i 5 Tot 7 ar a0 70590 el Sfetel tele l=lol lel Barve Prive Car Mie Private Car Mies Bazar ‘Arve aly Private Car Wage e aly Private Ger Mleege: % Depart rive [Day Prvale Car mange —— [Day Prvale Carte t Dagar ave Day Private Car iieape [Daly rate Car tage c Depa (Day Private Car Wien [Day Private Car Atoage 7 Fler lelSfelol-lelsizlel- lel apa Day Private Car Maaape Daly Private Car Ml ‘Arve ay Private Car age aly Private Cor Mi 2 Dapat Bee Prvaie Cor gE aly Prvale Cor ten 7 Dap Arve [Say vate Cor Wage S00 [Daly Private Cor Mieage. cr Bete [Dey Prvae Car Mieage ‘030m la Tar [Daay vale Car Atienge 0575 mi 7 [Tota “GRAND TOTALS ZEST 6s Total ise 6 | Form CNTR 003 Reimbursement of Travel and Other Expenses Incutedin he Dicharge of Ofici! Dury Form Stuctareiest revised July 2015 | NC Dapartment of Public Safey, Omision of Adminstration fren4345 ls 7-(4~ Mb | NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY (4(luzes- INSTRUCTIONS TOCLAMANT. Sune on etal Geno fexouing ach atracesary otal ects and cer ippoTng dosent 1s blading ay pie weten approval of exces enka, sgh, ana out tatsccuiyYavel Rea oe (1) coy fo" youyrocords Compete amour, ‘company, achunt and cnr fds. Fle teat monty aff ot late than 30 days ater mone ends. Prepare ik FD Brs3 5197383871 (om Enforcement ison sata Mighmay Pte] Towpe | ee set "ogrouiz016 010712016 ‘001 crs 9003 ‘008 008 cog —— Travel erow cach ay waned) (thor Travel Expenees| “rom > TrSiaw [oupiSae| — Eroianaion | Anoune co Ca —— ae ea, $10.00 $2130 a Se50 $2130 eae : econ aa so GRAND TOTALS $473.20 Pi core snntigin Ake RECEIVED ees [Ure rome ae JUL 13 2016 | Fm GNTR 03 or NGSH® Employee Reibursert MCC RSLARPOHONID: es incre nme ischaroe of Of! Duy From srr lst even Jy 2074 NESH Reseorch & PanningTravel eho each env ened) Tareperaton Suisse | ‘Cine Travel Evpenses Ory om © Slate | Oust Sin] Tn Stale [OvtSite| Etna Aart 2 "120 i T1000 $2190 Ge i mas To Es Bronte Gama t t T i a a ana ae game ya ne oe Sra ean aE lsyenwcarmmae Genta frssSnsmcsi eens (GRAND TOTALS For CNT ono NCS Employee Rerbrsement of Teel ané Or Expenses nates th Dich ofa uy Fer sere at veed ty 206 CSAP Resewen Planing | 2C11 Gd NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY vd REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY (AULD US INSTRUCTIONS TO CLAIMANT. Submit one ofiginal to General Accounting. Attach al necessary original eceps and aher supporting documents thie frm, Incusing any prior winen approval of excess regstaton, lodging, and ou-o-tatetcounty wave. Relan ono (1) coy fer our reores, Complete amour, 2 Fld. File at ast monthly and net ater than 30 daye ater month ends, Prepare nin or ype pany, accu, $79.753.3077 [Reimbursement for approved training expenses must be submitted fo OSDT. enforcement Division! State Highway PatroVEPD Trooper osrisi206 002 9003 O09 ‘pos mE 8 can 08 cm ats +e os ‘007, ‘aoa o009 FSEERZ Jew sfelie wed Other Tavel Expenses ime of departure and arrival in blocks in Travel (how each oly waked) TTaneporaie Suisence ‘raven [Amount Siaio [ Owain TeSiate | Osta “GRAND TOTALS _ 51800 jose acme ECEIVED a "he ot csase| = L MAY 25 2006 ia Dire seposit — NC DPS Accounting Reimbusement of Travel and Other Expensas Incurred nthe cf ofc! Duy Fou CNTR003 fee NCSHP Em NSHP Reseoreh & Prenning"T__ Otter Travel Excencos [sae al TOTALS BROUGHT FORWARD | Fom ‘her Expenses Incuredin he Discharge of Oticial Duty208 Extent biome joes NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY | / REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY © 36S INSTRUCTIONS TO GIANANT SuonWore oigralio General Acaarung_Atath all pecessenognel els and oer suppor ate approval of exces egtaon ‘ocging, and autot-satteaury Wave! Reta or 1} py yo eco Compete amu lnsstmonmy a not tar han 90 day ater month ns Prepare nko YEE (Payee's Work Phone Number 9187323971 Reimbursement for approves training expenses must be submitted o 0ST. _/ [200 Blount St Trooper Raleigh St _ [Ciy, State. Zp) Nawal Waring Hows (ora) Period Covefed by tha Request Wome) [Raleigh NC 27601 11172015 - 09137201, — nas = 137s ri anne = izle 0005 = oo 0005 08 a7 00a 0009 Taal Expense Less Advance Tot Due (Owe ‘Record the actual time of departure and arrival in blocks indicated. a (Cosi Aah Commission Stipend # Days. mst ‘SUBSISTENCE TeStale— | uF Sia SANSPORTATION. we Slate [ul OF Sate ‘Dire pees] 1090] 1870 wer 330 10:90 [Say Prva any rare vias Depart [Day Private Car Mieage Daily Private Car Nveage ois apa Day Povatetear Day Private Car Mage: x v 6 030i 0575s D575 hm rons 3 —s5 70 (2) Type ot Subeatence 0-0 NOTE: Davy ta tr sunsitonce PAID ciagten Si er | PF Eg 205 re Form CNTR 002 Reimbuceement of Travel and Other Expenses Incurred nthe ischaige of Official Duly 1 Oapaeente Pus Salty. Dono Admintton REC'D SEP 14 2015 |NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY Exevutne Delay) (WIS 36S” INSTRUGTIONS TO CLAIMANT. Submitone ongina!o General Accounting. Asch all naceseary anginal recipe and ctnersupportng documents otis orm, incucing any por writen approval of excess regisatn, loging, and out of aatlcountyVavel Retain one (1) copy fr you reords Complete amount, ‘compan, account ond center feds. Flea least monty and net later than 30 days afer month ends. Prepare in ink or hp. npenses must be submitted to OSDT. [Fares ee ener — vara] octet mot es 200 North Blount St Tapoper | Raleigh /S1 se n1g112046 - 08/01/2016 oars aehiLaae- LII)733-38. 7G 1 To ett} --H--H}— paca ete res L TH zt tatr ht atete} sean ay - a dao) [sar] O35 ye Record the actual time of departure and arrival in blocks indicated. Travel (show each oy vated) Transporation ‘Sunastonce ‘Cihar Travel Expanaes tom © 7] wise [ours] TnSiate [OuctSiwe) Explanation | Amour aa z ae 3 Best om sia ave $1870 ae 30. 31090 Ta Sema cone (GRAND TOTALS $880 RECEIVED _| perc sone aanee [bese : sl Fe To be NESHP Eng Rentsanat Taw Oh Enis aes ihe dscravee PREAH YG UL 2015 Form suture as revised uy 2014 NCSHP Research & Planingrecess ogaton 500 ron ws et ater ‘ater monn ends. Prepare ik or Wipe. NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY fou. aatounty oud any er Bayon’ wor Reimbursement for approved training expenses mus be submitted to OSDT. par Las lDivaonrSecton Law Enforcement Division / State Hig oVEPO [Payoo's Aacress (Steet) Tie ‘ Taber 200 N.Blount Street Sergeant RaleighiEPO cy, State, Zp) IRarmal Warking Hours (roma) Paviod Coverea by tia Request Fora) [Raleigh Né 27604 lana Fob 19-22. 2016 se paso pry TTT BATA TI Ty AP ANY - 2 RII account ‘007 0902. 0005, 0004; [oa 0006. o0u7 ‘co 0008 Total Expense 62.00 rz 7 ztt Z E700 Jeane ret bee) [E065] 7 shlie Cou sh Comin Spend so he 0 & ee i ae oar Sacrsme_|—taouer ea | ame + eo aoe Bis 7 ue Hs Dati cos Sa ita a a — to - a a 8 pa a cogs —— ga Tor bat rea oar ae ane - a Dez : : = a : $ ci a gS S050 F a Sousnat cy iiegs ——- tam at a ea aa Ha ata atmmaemteaiceel H+ Housing (Room) $7050 |RECEIVED: Fem amarante Deets wR 5 28 NC OPS Accounting‘SUBSISTENCE Testaie | Out OF Sate ‘iad To TRANSPORTATION. nSiate | Ou OrSae “TRAVEL chow 2amh From Day 5 Ris, Tae = = 3 "330 Depa az L S700 Arve 3. 5 S210) Dai Private 1 cH [Day Private Gar Mea 575 iil - a ta Depart t [ave o [Dany Private Car Mieage: cy [Daiy Private Car Mieage: 2.575 mi ‘or Depa ISaiy Private Cari [Dany Private Carte Om e Depart Bate [Bay Private Car Mileage 73a Baily Private Car Miea D575 mF lel lelS}=[ol-[=I 0. = ave [Day Private Car Menge: G03 Daily Pvate Car Mileage. Depa ‘Arve. [Dai Prvaie Car Wieage S030 [Daay Prvate Car mieage: 7 Depart artve (Day Private Car aeage [Daily Private Car tna Dasa Atv Day Private Car Wieaga: lol-[=|Sf=lol-[=|Sfz lolol Stole a T30_T Daily Private Gar Mieage: 0575 i ray Dag it Arve o [ay vate Car Mieage H aly Private Car Mle oI Depart c ‘Arve. 5 [Day Prvate Car Wrong: H [Daly Povete Car Mieage: 01 2 Depart L arrve D [Day Private Car E [Daly Private Car Mioage: Or o Da L Aitve Daly Private Gar Mieage: G03 Das Prvate Car Mileage: 0.575 imi GRAND TOTALS Tota Tota fees Toa ee z P = a o _ = A 3. ©. z A F o = Ei Form CNTR.003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Offical Duy Form Sirucuc last reviced July 2015. INC Department of Pubic Safety Divsion of Administration nist 216/201NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY UU TNSTRUCTINS TO GALANT” Sacro Gena icon Aa37 a ects atalcs ! Ge snavi ames @ Bm nara v9 wien apsrvaet excess regtator, 20909, and octstaeounyvave_ Ratan ne) copy fr your rears. Complete armour compa, 20st and cee Tels Fe Teast monty an not ater than 30 day ae mon ence, Prepare nko Ope Aentorernt or approve rg SAMOS a SST SrienSecion = Law Enforsrment Division / Sate Highway Ptr 5 43H rae eevorfere & Roar Loon slur sreet sergeant [nnegn E60 910 720387) fe, ae 25) o al Wargo] Fd Cavered by ts Reqs OOTY Rath nc 27001 hare rara20is. 124015, toge cones ncclommoabanatstesncinesan res oa Tose noe ost bar erst crane anspor ee vet ie [aa st si ‘0001 = = Sysy27771 T oor $e] eras tate tete I rate ot Shttrt ot HE eH on a ‘oar tr - - os = oe t ! aoe 4 3a Woetien [arse] Jail 05 2016 (2)5119 od artes Coto Caan eae “y= a AD SESE STE TS Depart ‘eve [bay Priv [Daly Private Car Mileage 12ers Depart ‘Ase [Day Prive [Day Private Car ieage: 7050 ‘$1870 1a Tot 5 Total 0.575 im Tr 330 Oe [Day Private Car Nveage S03 Tal [Daly Pvate Car Nieage 0.575 mi GRAND TOTALS 37H ia85 Toa Oo ype ot Subeieenen Sate node ot rat 3 bee ase Aonaverg Room) 40790 Jr tsaceeveuhrded ones RECEIVED cuisine Persie cate DEC 30 205 Dome ine HHoveng (Room) $7050, Form CNTR 003 Reimbursement of Travel snd Other Expenses incurred i the Discharge of Oficial Duty Form Stuciue las vied July 2015 INC Deperiment of Public Safety, Divsion of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Faccufine Outi | REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED i il IN THE DISCHARGE OF OFFICIAL DUTY 43657 vein approval of acute ragitration signa, ana out otatatteurty Pavel. Ratan 278) a Corlee amount smpary, acc0ur and cane ee Tabet mony a9 not ater than 30 daye ata month ence. Presa nko ype [Payea's Work Prone Num Reimbursement for approved training expenses must be submitod to 0SO7, mg ea. ps7 DivseniSecton Law Enforcerent Division / State Highway Pat 2%, Tite Nomber 200 N siount street Sergean Raleigh’ EPD 918.733.3871 ci, Stale, Ze) Neral Working Hours (orto) Raleigh,NC 27501 tare ” ate) Goot 0002 ‘000s. ‘000 0005 006 ‘0007 00 ‘ood Total Expense | $ Jo Toe Tot Due (Owe) [3— a folie dt acus in of departure anata nek inde Coa Ash Conmiesen Spend toon 000 TRAVEL [Show each oly wale) TRANSPORTATION io TnState | Ou OFSiatS SUBSISTENCE TnSate | Ou OrSia rer Travel Expiansion ‘Amount Day Tees Depart ‘Arte [Caiy Privateer [Day Private Cor inane PPPIES Depart rte Daily Private Car avenge Dally Private Gar Mieage Tas Depart ‘Arve [Baty Private Car Moa [Daly Private Car Nieage 30 0.575 imi [a Torar 5 Toad Tl 7 a ©. z o (0575 mmil-P a0 GRAND TOTALS $7580] — [eas Tora hiss (2) Type of Subsistence: State 1) ode ot rave: 8 Breaks: 3830 P-PrvateCor = Other ral, busta park feet AZAk R= Rens Car tunes $10.90 Dinner 31870 |NOTE: Daly tit for subsstnce Mowing (Room) $6720 roto enced autered run our state lerinstte cut ot tte wave! 1 Bresitat sa20 tune $1090 2 -Diarer $7130 H Housing Room) _§ 7 Form CNTR 009 Reimbuceement of Travel and Other Expenses Incurred inthe Discharge of Oficial Diy Form Structure last revised July 2015 NC Department of Pubic Safety, Division of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. Ht des av Aecoing_Atach al recateary angeal recalls An ha ipporingSocamant form uae any por ty ravel Reta ore) copy fo" you ecards Coma aun company aecourt and cnt els Flo 3 4 sean inter han 30 days ator marth ence Prepare minke tips Reimbursemeat fr approved Waning expenses must be submited to OSOT. gos Wor Prone Number aa ————aiioniSeation Law Enforcement Division [State Highway PatroVe mbar f hae suroare [natoigvero iin Ste 2) rama Waren as OTT Para Corea by Fs Rea TOT Raleigh,NC 2760+ sas? 9/18-19/2035, ‘Use pee pay ESV RA BFR BT REG ISTE TE Tine Sanined Ba EIR Teun and oa RAT SST 200 NBlount Street N eee Talal Expense [$4880 Less Advance Tot Duo (Owe) [$4880 . Record the actual time of doparture and arrival in blocks indicated, ae Coal Ash Commission Stipend Days 315 TRAVEL Show each aly waded) . $0.00 TRANSPORTATION. TeSiale | OuOtSate ‘Cir Tavel penses Blanaton | Amour ‘SUBSISTENCE miele | ont State 10.90, S18 70 z F 1a Tova — 030i FOE ]s Vota 0575 Dally Prvaie Car Mileage Daily Private Gas tAioaao was apart Atv [Daiy Prva Car Mseage [Day Private Car Neng a 2. Toa 5 Total Dapar arte. [Day Pro Carniieage Daily Private Car Mileage lara Is Total aS TouaTNae @_030_Ta 0.575 ni GRAND TOTALS 0) mde of Tevet: P-Pivate Cor O= Other, bs, ta pating ees A=Ar R= Rerlal Car Rowing Room) $8738 EVER outer state Ierinstt or out of seve PAID res | OCT 09 208 H-Mousng (Room) _§ 78:50 Farm CNTR 003 Reinbrsonet of Tavland Other Expenses eure ne Discharge of fi eee SEP 28 2015 NC Department of Puc Safely Division of AdminisiraionNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY _Execuhe Dela.) IU 1! e365 later than 30 days ater month ends. Prepare in nko ca |____Roimbureomont for approved taining expenses must bo submited to SOT. [PusevSecon £7 | fe — irrecords Complete amount comer secour rd center els Fes 2O0N, BLOUNT STREET 2 _ - (Cty. State. Zp) r s “Fad Cowred by iis Request Fonva) | RALEIGH NC 27601 7120/2015-731/2015_ _ apploate thae ga Tea Ears = tooo Aer Le BOT ‘Tot, Due (Owe) ue vf ctual time of departure and arial in blocks indicated, ‘al Ash Camnission Stipend Days SIS = 30.00 TRAVEL Chow each oly vated) TRANSPORTATION ‘Other Travel Expenses ‘SUBSETENCE 35 a aE ae 850 ep t[$——ros0 on a — n al [Baty Prvato ar Mage Dally Prvate Gar Meesge Frsare: Depart ‘ve [Day Private [Daly Prvate Cer Mesze fs Tota 73 230 7020. 1870 = a 5 s AT) 230 ia Tota 5 Total fats rom wae 7 S810 {B Typeot Subeletence:n Sale 0.575 fm RECEIVED | eee Ss ee | - Dine Form CNTR 003 Reimbursement of Travel and Other Expenses incured in the Discharge of Offical Duty ING Depron’ of Pble Sofey, sin ofAdmisraton RECD Aug 94 2015NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Sue Pe REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED INTHE DISCHARGE OF OFFICIAL DUTY Ay esos (Pele TSS 2851 Guparssar Tephane fi LI Pa eat { Ls Adva Tot Due (Owe) [F Sine Travel Espero sganalon —| Amour Ts Deport [any Day Pivate Cart 1 ra (2) Type of Subsistence: inSiato (1) Mode of Travel: Breaks se IPsPrvate Car 01= Ota ral bus, ching ees R= Rent Linen —-——— Accounts Payable Form CNTR 003 Reimbursement of Travel and Other Expenses cured inthe Form Stucture ast revised Jy 2015. NC Department o 1, Dvbion of AdrinetratienNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED au [4 UZeS » IN THE DISCHARGE OF OFFICIAL DUTY PPreswonrerernber ——si67s53e7i | _momune : Taba Tite Trooper ours (romfay (iy. Sate, [ateign ne 27600 [Paved Covered by tie Request (rere) ISN 266, era Wa itactip bio ‘Caley or Telephone ®) a EX “0002 Wo] 1] T aE i = =e He ‘0008: T Tot. Due (Owe) [S 7 ZL 7r2Tt t An z i im Bere K 22 20K Bhlie ctual time of 3 and srival in blocks indicated Coal Ash Commission Si # Days $0.00 _ TRANSPORTATION Other Travel Expenses SUBSISTENCE TRAVEL (Show each Gly visited) os = T[—isiate | Oe. 0FSiate TnSale | OutOfSaie | Explanation — | Amount BAST z saw Depart A ‘$7080 ave 0. S170 Day Private Car eage Doi Pivate Car Micon - Twa] rare m = a0 Depa x $1090 ‘ve 2 Day Private Ca P Daly Private Cor ea 0575 il Set = a ‘ve ——~Ts pay Prva “oom le roar Baty Private @0575 mil F Tour TRAN TOTACS 7a 5 Tota ae Tipe ot SRE STE i) ode otra Bees sex0 | c teen siov0 IP Prvate Car O= Otero bus, ti paingioes AA Dimer $1870 woTe: Dab tit or substoce Hous 55730 {notte exaed sumac aru Breast, sa30 ize | RECEIVED | | i-vousing com) _§ 73.0 TTR 003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Official Duty MAR 15 2016 Form Stuctre lat revised July 2015 NC Department of Public Safely, Division of Administration NC.DPS AccountingREIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY MUW3¢ a eer aa —_— file MASTER TROOPER Taner FRaegh fay, site. Zo) iomal Working Hows (rary Peiod Covered by this Request (roma) RALEIGH NG 27601 _ HATE 7owi6 7226 Tr protee ol pe CP : Ts aT SERS SHOT FATS TF 5 AC bppnomt BLOUNT STREET ‘Catey ‘Gurenvsar Telephone #) “0001 = T B]3]2]7]1 T T ‘0002 + Si[3l2i7lal@ el SI oat Hee EE =| eo ae - =: = FREE ode fr—ae Ee insta, bara BM Iowan tn rn i rt Hooke ie ee a aor ec a a z - A — 7 L cauneeeigieen: é L —_—_——e a a — 5 Depjirt_ A [xe o aL : os 2 eee ae |_Depart eerie — }— a = ia asco mage ——g oa o fees a a — ——— — Private Car 0 Cite, albus, parking ees =A INOTE: Day tt or cubstonce ret to exceed autonses ar for state or otorstate woe: -Dinee 4 Housing (Room) ical Duy Form CNTR 009 Reimbursement of Travel and Other Expenses incurred inthe Discharge of Foe Structure ist vised ly 2015 INC Department of Pubic Safety, vision of AdministrationREIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. LAINCB OS Sant Siomtone ofgral io Gerera Acsuning tach a neoessay orginal reepia and ofr suaporng docubet ofa om eudea ay pact PAWN oon ogg. and oucstatlounty ravel.Relan ane) coy fo You rears. Comeele CUM, company, acu, an cart as. ile at fee en 9 eye ao ert o.Propere ne Yo TTF manent ag wan mn nei i o8 narod paantraon wasren RooreR — Rama anrg to aay Paiarceeel St Ragas FORT ito ‘ —_ ai eae a tanner agar ~ Bo. (ate) {Supervisor Tetohone ¥) ‘0001 i ‘oc 3 z ‘0008. FAK tooe Sees 008 teoe a oe Tea ease ae Tot Duo (Owe) [E896 a) /ie Recora ots rival in blocks indie Coal Ash Commission Spend 2 Days. xSI5 = $0.00 TRAVEL [Show oath oly vied ANSPORTATION r-Siaio | Ou OF Sate Cina Travel Bx Explanation ‘Amount SUBSISTENCE Tesi | On OFS Da TATE Dagan Day Prva Daiy Praia Car Vion Taare Depa aie Daiy Prater Daily Private Tae Depa ‘tes Day Prva Ga Mseape Daag Private Gar Micage ar Tor a0 “Total — e398 (5 Towa 030 imi zr 330. 70:00 21.30 = > = 3 la Tara 3505 Toss Sooo s 61 60 ads Tor eG Tipe ot Sabato Sate 0: Oe 0.30 mi 2575 inl F 1) Mode or Travet IP-Pruale Car O Oher albus tax parting fees A= Ar Ione: Oni tal ox since fot exceed auerzes amount feristateo outotstate rave ae ‘ne O- Bere W $2190, H How Ss $7080 Form CNTR 003 Reimbursement of Travel and Other Expenses Incured in the Discharge of Oftial Duty Form Structure last revised Juy 2015 [NC Department of Pubic Safety, Dision of Administration‘mewn Oihar Tava Explanation ‘SUBSISTENCE TnSisle | On-OFSiate TOSS 61.80 TRANSPORTATION inSie | OutOrSiate r rm Arve. Day Private Car Mle [Gay Private Car ig ABTS at Arve (Baty Private Car Wea [Daly Private Car Mi TABS ‘Depart ‘artive Daiy Private Car cage: [Bai Private Car Mie Tae 7 Depart Arve Daiy Private Car eage [Daiy Private Cor Neage: Tai 2 Depart Arve Private Car Mileage: Private Car Mileage" 7 z =[>[-|= 5] =[ol-l=|S}=[ol-lel Stele ot Bi Da TET ‘Depart “Ave Day Private Car Wieage: [Daty Private Caran T2316 Depa ‘tive [Gal Prvate Car Mage [Diy Private Car Nea ee o Depart Alive ay Private Car Wien aly Private Car Mileage: TER a Depart Airs aly Private Car Wieage: aly Private Car Mileage TB. o De, Arve: Daily Priva Car cage [Daty Private Car hie rT 7 ar Arve [Daiy Private Car Wieage [Daly Private Car wieage. 7 Ie Taser Total lel-[a]Sf= lolol] =[>}-lelat=[ol-lalatalol lol ata iS Towa ds Total se By 30 575 imi GRAND TOTALS al=l=\--| WOE Form CNTR 003 Reimbursement of Travel and Other Expenses Incued inthe Discharge of Oficial Duty Form Structure last revised Jy 2015 INC Department of Pubic Safely, Divsion of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED INTHE DISCHARGE OF OFFICIAL DUTY [AUG3@S~ lBwisonrSecron Law Enforcement Division / Stale Highway Patol yous Aactese (Steet) Tite 200 NORTH BLOUNT STREET MASTER TROOPER, [cay State Zp) [Normal Working Hours (emo) Feta Covered ty tis Peau emo) RALEIGH _NC_2760%, Nati [ozarse= 246 Sas erih oa Ta TNT mah TRS Un reas Unser aay as a ae Daa Ta TL Mopac Yoophane 8) T aot TF Zaye i T tao $a periete Ta ars 03 [4 = efapettate ‘00 ——T$ [- s]afe | ons 18 = sto 006 7 oe ‘0003 es es r Toa pense |S 6a ca Less advance Jie Tot Ove (owe) [56a a " of Cou Ash Commission Stipend toon rss 000 TRAVEL Thon oT TEANSFORTATON SRST rar Tal pes Oy Fi Sule | OWS |Z] Sale| Outs | —Eeioraton | Area C22 Depart Ag [Daly Rvaie Car Mieage =a ca) 330 70.90 18-70 3575 il Oat Daiy Piste Car tieage Dany Pea aay 0 Daiy Private Car Mieage [Day Private Car Wieage, ES) 320 iz Toar 1S Tor faRS Toate Eg 030 iri 0.575 im, = sao TH {Bi ype ol Sueinence In Sate 8. Brats s830 J-Prneie Cor Ox Obra, bus tpg fees ABA Reenter Le tunen $1090 Dimer 51570 |NQTE: Osiy tale seoateace | HoMowsng Roem) $8739 rateeoeedatoeed arcu | tune $1080 i Movsing oom) Foi CNTR 008 Reimbursement of Travel and Other Expenses inured in he Discharge of Offa Duy Frm Strate laa ese Jy 2018 NC Deparment of Puss Safely, Dion of Aérsnisiratonyee cane pepaEnUr Punt Fee > REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. (SUNG BCS anong_Atach al recessry orginal eves a6 oe opr er yourrecors Complete sour company. acount an antral INSTRUCTIONS TO CLAMANT Gubrt one orgnal fo Genera ring dacirerts tos fm, RoUSRD ay par sien approva of excess ition, odgna, and cut of tnteounty rave. Reta one Flea less mont 1d et lator than 20 daye ater marth enc8Frepere nino ype Reimbureement for approved traning oxpenses must IDwsonrSecion aw entorcoment Division IaaSTER TROOPER [Payeos Work Phone Number 910735.3871 sor. Location Name & Number Raleigh Si Rromal Warking ours (roma) Pariad Covered by tis Request [ronioy ier 5/6 5 S-/1-20/0_ LB IE ZY ~ (Sapenngor Telorone #) FAI Z ooo - W280 | Tao el 2008- LeseAdnes Shen Tet Due (Owo) i acord the actual tine of departure and arival in blocks indicated, spelt 2 Daye, xsI5 = 30.00 Coal Ash Comission Sipens Giber Travel Expenses TRAVEL (Show each city visited) TRANSPORTATION TENCE To +] In-State ‘Out-OF State | 2 ]_ Out-OF State” Explanation | Amount 1 o| $s 870 _ $ a t fa a oe Ta a et Fa a tfs—i08s tee 3 3s [DaiyPateCacmangs———g-030-ma nl a easel ae Saal - rs — tte [- 6} —— ats Daly Pate Co-nieage ——@-00-Fa a raat [bay Peat Cowie 3375 ma ae Sa TO TOTACE = $a fae TTS ES | riper Sao ne od ot rae foe ane tne x "Done: bu pong eee ATA R= cor ttn 090 st RECEIVED Hawt eon) [eee tomas Pda Orpowt Wy oe one cia Sse MAY 25 2015 ent 30 NC DPS Accounting HcRowarg oon) $7850 Form CNTR 003 Reimbursement of Travel and Other Expenses Incurred in the Discharge of Oficial Duy Ferm Structure let vie ly 2018 NC Department of PLlic Safety, Divison of Administration As‘Other Travel panes Explenaion | Amour SUBSISTENCE — Stale | OucOFSiate ‘45D 230 TRANSPORTATION "TRAVEL how bach Gly vate InSite | OuOFSiaie From To TOTALS BROUGHT FORWARD z ay 392075 z = Depa ‘Arve. 7 [Daiy Private Car Micage: [Day Private Car Moone Depart Aitve [Day private Car ieags [Day Private Daz Bare (Day Private Car nage [Daly Private Depa ‘rv [Daiy Private Car taeabe: [Day Prat Depart Asie aly Private Car Wenge iy Privat Be ‘ve aay Prvaie [Baty Prva ‘Artve Dai Prvate Car Wieage: [Day Prvate cor Wieage a Hie iy Private Car Mina iy Pra Depart Bere | [Baiy Private Gar Mieape [Day Prva Depart Arve [Daiy Private Car Wb [Day Prvate car a Site Day Private Car Mage Daily Prvate Car Mieage Depart aerve: [Daly Prvaie Car eape la Toa 030 mal [Daiy Prvate Car hhleage 575 mi GRAND TOTALS THEE. Form CNTR 003 Reimbursement of Travel and Other Expenses Incutted in the Discharge of Official Duty Form Stiuture last revised duly 2015 > NC Department of Public Safety, Division ef AdministrationNORTH CAROLINA EPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED = IN THE DISCHARGE OF OFFICIAL DUTY. 1ALUS eS TWSTRUCTIONS TO CLAMIANT. Sob one cignalio Gora) Accnuring. Alaska ecessty orl eco and ofa suppor daaivarsts Ts Yor RAL estan approval of cae egtaten dpa, a3 atsinnesinny wave Fatah oe (9) epy Yu! ecoss Compe mart earpary, aes apd canes Pest meni nat ter than 30 days ar month ans. Pera mk pe. 1p ane aa er eT nna i nea ss os la — vem aaa "tia ioe es aceon ra aa ‘ice ins of ay TRY RE ES RBS ai hve venir opto fr overeat ard pase he GLE Bate) LIL IS 72 LEE, ai 1 4 rtp 7 +97 eaters | —: i s—_ = Tolal Exe z 37.90, a * - Bor 27 ses > fuser Wn crate teks a o/alie cian ores meee othe Te mam SESS ne “TRANSPORTATION, Ou OFS TRAVEL (Show oath Gy vateG) in Sate TStale | Out Sia] Expansion O50 78.70 laren 5 Toal [Daly Private Car Nleage Dai Pate a7 Ba z a = Is Teta — 7 @ 030 Mileage [bsty Private Car Mieage @ 0575 oT (aaa 3 Degae L Bate 5 a Tar weeps) 0307 20575 [Daly Private 5 Total i oH Dai Private Car Wa ‘GRAND TOTALS 3 a9 fads Tole By Gy Type ol suntan mse |) od of trav 8. Boots so | JP-Pate Cor "O' Ohwra busts patingtees — AsAr Re Renae tune $1000 ©: Dimer $1870 fore: osiy iar sweitence heist aon) Ser30 frogs nared ane D- Besa 3930 the Dischage of Ofela! Duy Form CNTR 003 Resmbureement of Travel and Other Expenses Incr Fou Stutue lal revied July 2015 INC Deparment of Pubic Safety, Diision of Administration“TRAVEL [show onsh cy vane) TRANSPORTATION SUBSISTENCE To. He OFS a TOTALS. FORWARD, SESSERESS: rile CR TER Day Private Cr tse 3 = 2 . a a P z BSEEGSES ay Private Ca ie [Daly Private Car ieage. 3 ‘Arie Pre CaF WBE iy Pivaie Car Me Depa ‘Aa [Day Private Cortieage: [Baty Private CarMloage 2 ‘Ave Tal 0575 7m =| ofol> [>] =| =Lo]> [a =] o|o[>[=] =] slole al =] Form CNTR 003 Reimbursernent of Travel and Otter Expenses inured in te Discharge of Oil Duly Ferm Siete iat roves July 2018, NC Department of Pubic Sefety, Divsion of Adminstration or ‘Omar Travel janatonREIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED s IN THE DISCHARGE OF OFFICIAL DUTY (ALU 3%: Teinal to Goverat Accovabng_ Atcha necessary onal vecate ard her svapaing dacumera tots form elvang ary pre miskor te |__Reimbursement for approved taining expenses must be submited to OSDT. [Divan’Secion in [eocation Name & Naribe poo NORTH BLOUNT STREET | NASTER TROOPER _|Ratigh city, State. Zp) Neral Warking Hours (onto) Peicd Govereo by tvs Request (Fo RALEIGH NC 27601 Nae 26/6 2091 apna of pny ROS oF SOS RASTA Tae SaTST RESTA OR nd CO FTG aU aro {! ees Tite X50 TOIT ‘oot [toe 003 oe G00s: 0008; ‘007 ‘oo a ‘0008 Talal Expense [$7.0 MAR 10 208 Less Advance MAR 1G 205 Spalte Tot Due (Owe) lolol alo Coal Ash Commission Spend X515 (Show each oy waied)_ ‘ier Wave Exgeraee Exglanaion — | Amount SUBSISTENCE TRANSPORTATION. OuOFSate Tn-Stale | OuLOFSate Depart ‘rive Day Fi Daily Privat ar [5 Tota Daly Private Car Mileage 2030 [Daly Private Car Nueage: mi 5 Tota Depa ‘Ate Oa a ia ca ge pan vas carts Sara mar] aaa TOT rm Ca ipa sae (yaad bee ae [Pee "oc ok mk aces AAR Rac turer som Side S187 ME, oat nace ovate amutt anon to bom ate chee aon) 3 7a Form CNTR 003 Reimbursement of Travel and Other Expenses Incured inthe Discharge of Official Duy Foim Structure last evises Jay 2015. NC Department of Puble Safety, Division of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED i" Fenner ter IN THE DISCHARGE OF OFFICIAL DUTY (ANU 30S TNsTFUCTIONS TO CAMANT” Suonone sora Gonwu Accmtrg Ansa recewny arora ono ad cer usp Gooner ois om meus ay ar tun rot fexcnempsanen gy. covery re. Ren oe ce Your coe conan tadarr tes Fe inst ony ard ot ater Chan 30 days afer mont eras repere nik 2 pe o19-755-3871 Reimbursement for approved ing expenses must be submited t 0807. DvisanrSecton i | Tie 10 N_ Blount St Stole Trooper Norma Workag Hours (Foro) Fr eae ore Red Sie, 75) sigh NG 27601 [Wate 2206 Se ate obey wa TO : ieee Sapervser Telephone # - ool r T 7 nwo sour | conpany sccour cexren ‘0007 z = BT3]2 T T T TT ‘one $71.08 TDs st2triata Z| Bi cous ——Ts statatrtayt o03¢———[ 2 sate a0s——T$ z sa 005 t ka + 007 >it 00 — SI 7 5 —- 0008 t mas rt Taaespense [$7 TOW om Tet. Due (Owe) [$7 72200] #4 |! Cost Asn Commission Sipera fon et ee ee 7 _ TEAVEL Show 0001 vie)[ —HANSPORTATION “SUBSSTENCE | — oar Ta Epos orm From oT] eSise | Os OSHS | 2] State | Gu-OTSate | —Eoplnaton —Anoord rain z 3 7 Deport z t 00 are 2 3 187 Dany Pa * t a Iraar Piva or aoe fra a 3{s——_a%0 tTs——i930 ate 3 ofs—1a79 Dany Prva Carica @ oar r 7 Ta ay Prva a iL aS ae Tota Besar i tts —7080 ‘ae 3 ops 71870 Daly Pe Car age Taal Ta Daily Prvaie Car Meat: osreb oS TT sro RanB OVATE Tra Type ar Subanon: Se (mo @ Bent a838 O-Direr $107 |uore: oat tater soestence oworsine jeewaecrcnaaaene | —— Harem RECEIVED : age of Ofc ol and Other Expenses Inoured in th Form CNTR 003 Reimbursement of T Form Structure last revised uly 2015 MAR 15 2016 INC Department of Puble Safely, Division of Adminstration NC DPS Accounting‘ihe Travel oes Expanation STENCE. Out Fate TRANSPORTATION “TRAVEL (show each ay wised) Tn-Siale | OutOFSiate From: To TOTALS BROUGHT FORWARD TnSiate 7370 630 Tame Depart Arve [Gay Private Car Mea Day Private Car Mieago: a Arve. iy Private Cartage Private Car Bi 7 Depart Arve Day Prvate Car fangs Daily Private Car Rea 7 le|-lo[S]=[=\-lelS}=lol-f=! Depa Artve: [Gay Priva Car fae [aay Private Car Nie a Depa ‘Arve Daly Private Car waage Private Car Mieage: ° Depart ALive [Dany Private Car aieape 030m Daly Private Car Mieage 7 [>] =[o]>[+| >| =]o)>[] | oJol>[=}o| la] =| slol> lal ol olole| af Depa ‘Arve: [Baiy Prvato Car tiTeage @ 0m [Daly Private Car Menge 7 ar Ave Daly Private Car mage Daily Pavate Car Mieage: 7 Day ‘Barve ay Private Gar age aly Private Car Mi o Depart ‘Atv aly Prive Car heage ay Private Car beage: 2 Daj Arve. ay Pavate Car Mieage: e030 i aly Private Car Mileage 7 Depa Ave Daly Private Car Wioape: ©_03_Tal la Tear [Dniy Private Car he 0.575 mi ray 5 Total GRAND TOTALS leks Tora se Fy Form CNTR 009 Reimbursement of Travel and Other Expenses Incurted in the Discharge of Oficial Duy Form Structure last evised Jy 2015 NC Department of Puble Safely, Dision of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Sagecarte, Cold DPS REWURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 4i1@res = 7 _s0200 u —- Tot Due (Owe) za Coal Ash Commission Stipdh pinnae oor RECEIVED™'* reg 04 2016 Accounts Payable‘GRAND TOTALS Form CNTR 009 Reimbursemnol of Tavel and Other Expenses cured in he Discherge of Offcial Duty Fea Structure last rewaed July 2015 NC Department of Pubie Safely, Dwsion of Adminstration TRAVEL howaash ay vate) TRANSPORTATION ——T-——~SusSISTEN [cir Tava pn Day From To i InStale | Ouw-OFSiate [2] in-State Ou-OF State Explanation Amount TiAl BROUGHT FORWARD i aroo E T1816 «4 TRI [els 830 - [ Depart ny Ht mie 3 i Dany Pe reer e + Ie Toar Diy Prva Cartage @ 0575 imi oy So 5 Toa [Depart —— — far fe Ave @ o ay rn Caras Soar fe r3a— Bay Pits Car teage Bare mle 5 Tost ec m Dasa — —— i wees ot iy Prva Carian @ 00m P| Toi any Pre Cartieage a7 Imp P 5 Tout Depa * : ane ° ——— Dany Pate Car Wane aml ry — I Tor [Diy Prat Car loa 3575 mal icac 1m = Depart Tat t == ‘ive | —— 3 t [iy Pre Carag G00 P raat Baiy Pre Ca Nieage Taal pasa = i = == ate — [ay Piva Car age Seat es 1a Toa Day Prue Cartage 576 nf P Tot Depa i + ative a7 = = Daly Pale Carag 60am i far Dsiy Pre Certo @ 0575 Ini 5 Total Dasari = 7H Aaa ~ Day Pre Carnaeags Tat Bai Pain Cor Meage Toi z Dasa * t — To Car age aoa = = [Taal Car Henge @ 0575 mF = oat 1 = Aq L To 4 Tt = Day Pre Car ege @ 030i Teta Day Prats Caritage oss mF TS Toa Depa i - ae Baty Pte Car reags eee - a —t | Smee P Prvaie Car O= Other, rat, bus, taxi parking fees © ASA R= Rental Car Le Lunch } | RECEIVED and f Other age of O of Travel ar Otter Expenses a sorry vec NOV 04 2018 { Rousing on Form Structure last reve ly INC Department of Public Safely, Dision ef Administration‘Diher Travel Expuaation ‘AnoUT ‘SUBSISTENCE TnSiale | OurOFSate 27 TRANSPORTATION — TeSiate—_ TRAVEL (Show a50h Cy VBTES) Fran i "TOTALS BROUGHT FORWARD. hel Da ee iy Pavano Cat Wicage [Daiy Prvala Car Meane 030 05/5 i Capa Bee (Day Prvale Car Wiese Bs [Day Prvate Car wioage: Depa [Say Private Car [Daly Prvate Car Ploage: Cpa itive Day Prva Car wena em [Gay Private Cor Mieage D575 i a [Dy Pre Carnage Daly Private Gar Meas elo S]=lola lat f= =| =fol>| |=] =[5]> [=|] 2lo]> l=] o[elols|al =| lols fal ‘rive iy Private Car Wreage: aly Private Car neeage! @ 0575 imi Depa iy Priva Car Wea any Prvale Cor Meg Dana Ave [Daiy Private Car oa (Day Pate Car Mag Dasa ave [Gay Private Car ieage: @0% [Daly Private Corntieags: aa [Day Private Car oa Dali Prue Car hea Capa Bie Dati Pvaie Car Moa aly Pavale Car tea Dey ie iy Pave Car ieage ay Private Car Wieege lel fe |Sf=[>]- [oS] =lel-lelsl=lel-llay= lola le Tota 5 Total [aes Tom 30m 0.575 z o . o. e = e = 2. mE Form CNTR 003 Reimbursement of Travel and Other Expenses incur in the Discharge of Oficial Duly Foam Stucture lst revised July 2015 NC Depagiment of Pubic Safety. Dison of Adminstration — My Yona pes ATexecune vem REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED _ rare IN THE DISCHARGE OF OFFICIAL DUTY. Wy) w3es INSTRUCTIONS TO CLAMANT” Sobol one ogjalro Genera Acsouning_ Alach al recessary orginal recaps and oer supparng documents ths orm, stensprova wrens egtaten lodging. and cutl-eatmcnuyYave. Reta ore ') copy fr your records. Complete amount Company, account cere ‘oat mary ana nt later than 30 days afer oth ends. Prepare in ink cr i "aye’s Wok Phone Number S19-7353877 Reimbursement fr approved ening expenses must be submited to OSOT, TBivsoniSecton 7 [Law Enforcement Division State Highway Patrol Tie EN [trooper _ Raleigh St Norma Working Hours (onto) Pered Coveres ty ie Roque tat 0928115 - 0922/5. te Sievert toni, Ihave gwen pa pena lo ewig ave ata use psa he oun company T wo280 Talal experae | $103.50" Less Advance =o Tot Due = \ eee fecord the actual imo of doparturo and arrival in blocks indicated Coal Ash Commission Stperd om #00 xsts 3000 Sher Travel Expenses Beplanzion | Amour Tavs “TRANSPORTATION TeSiate | OuOtSiae Show each chy vated), Day 92S a Total 0575 Brive rc [Daty Private Car Menge 030 im! [Daly Pvate Car tage Sn Bers [Day Private Car Mueage [Gaiy Prvate Car hiveage eT 5 Toll 2 030 0.575 ml P GRAND TOTALS | {By Type of Subuetonan In Sate 8 Brook $030 H-Housing (Room) $87 % lo to of Tava: P-PrvateCar = Other, ral. bus. tae, parking tees ASAr R= Renal Ca 8 Breakin! s i -turen 5 | 1G gy © Onaer s21%0 | tec vewsng oom § 79.50 Form CNTR 003 Reimbureement of Travel and Other Expenses Incurce inthe Diecharge of Official Outy | Form Stusre onttvsed uly 2015 RECD SED 3.0 ons INC Daparimant of Pubie Safaly. Division ol Adminstrationier Travel Eenses Explanation —|-Amourt SUBSISTENCE TnState | Out 07Siate 9450 TRANSPORTATION Tn-Siale | Ow OTSae [ne rear enya ba To Front z Sar EORWARD 5 = Sous Dogar [Gay Private Car Mieage. Daly Pavate Cornaeage ats ‘Dapad Tae [aly Private Car Mea [Daiy Private Carnveaze wns Depa ‘Awe (Day Pate Car tiaage [ay Private Car Mien TOTS Depart aie Dany Prive Cov aon [Dany Private Car tien TOZA Depa ‘Arve Day Prvale Cor wieage: Sow, Day Pavale Car Mieage Toa Daly Private Car oa aly Povate CarVieage Depaa Hive [Baty Pate Carwieage [Day Povale Convieage Tass ‘Depart [ay Prcaie Car taoage [aly Povate Car ie TOeAS Depart Rite [Day Povate Car Mieage [Diy Pavate Cor Mieage Tas ‘Depa [any Favate Car Mea [Daly vale Car Mieage Twas Day rae Car Hoag [Bay Prvaie Carvieage Taos Bee [Bay Prete Careage (Day Prvate Car Mileage: [a Tatar 5 Total [a8 Tora Msc ED oa 0575 im ‘GRANG TOTALS TEs Fou CNTR 008 Reimbursement of Travel and Other Expenses Incuced in the Discharge of Offical Outy Form Struetut ast revieed sly 2018 INC Department of Pubic Safety, Division of Administration aEen Dud NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY. il WZUS\| "eporing decom fo Pie form Fessing ay or INSTRUCTIONS TO CLAMANT” Sit ane opal fo General Aosombng_ Ao) ak necessary and " tila approval exces eptaten 10g. an8Ou--statteoutyYave Reta ore") copy fr Your fecaes Compete amour company, ecco. and center hy and not ater tan 20 days ai monn ends Prepare mink oye. Reimbursement fr approved training expenses must be subsited to OSDT, "Wore Phone Number _8]9.730:387 f | ll re aw entorcemont Division State Highway Patrol 2A v | } x eg 1200 Blown Iciy. Stato. Zo) ~ Normal Working Voure (rama) [Period Coverea by tie Raueat (remo) Ralegh, NC 27601 lenge sins. 925 25-20)S— aleprone #) 3007 ‘2 O60 ‘O00 ‘005 000% ‘007 z 008 008 Talal Exper Lose Advance ext Tot Duo (1 yo se's Coal Ash Commision Stperd nw #oay0 1515 TRAVEL Show cock oy vated] SUBSSTENGE Giher Tara Expenses —] Da From 3 7 Z[—eSiate —[OucOr Stare | —Expanaion — | Amour] 7S i s a +r Deoar a ifs} = ae of} — ys ——a70 | ary Five CoP me i jz =a [- iy Prato aia t ors 79 wa a a Besar —_ Te = > = = ve © o. Daty Private P : TRRECEIVE! Day Prat Cor Wenge) 0575 mF oe FT Sra =D a Fl] —pr— eats Depart A i CUT O 4 2655. 2 3 3. Daiy Prue Caramteage ——— O30 Tal» 7 oo | 7 = [ost Prue Car Mieage @ 0575 mi Pl rat S Tolar Granb rorms —T c <5 fess Tou inae Expl Ta Typee Subenee TNS ae of rave rest! 020 Protea 0 Ober ats te paningtees AAT R= Rela Co Utne s0 | Housing (Room) § jot exceed aurorzea amount oust Sate formate oot ane av PAID 8 Beals 02 0 -De $2120 BT igs teaaiemm 3h | | Form CNTR 003 Reimbursement of Travel and Other Expenses Incuted in the Discharge of Oficial Duty Form Stuctue st evced iy 2013 REC'D SEP 29 2015 Safely, Dision of AdminstrationGis Travel Ey Ewianation SUBSISTENCE TrStalo | Out OF Sate a7 TRANSPORTATION in-Siate | OubOFSaTe (VEL (eho oa Oy VED Foon To TOTALS BROUGHT FORWARD z Bape Bee (Day Prvate Car Wiens oo [Daly Povate Car Mileage: 0.575 im BVALUET G03 O75 i [Dsiy Private Carle age: AUT Depa arrive (Dany Private Car Weage aly Pivate Car Mleage HAE: G30 2575 I ave Private Car og Private Car leage: WAU! Bere ay Private Car Ming aly Prvate Car Mieage ALE! Rave [Daiy Private Car Miieage [Oaiy Prvate Core HRLEL Depart (Gay Pvale Car wieage [Daiy Private Car ieage DEST 575m Cah 0575 im @ 030M 0.575 imi e030 0.575 mi lel -l=|Sf=[ol-l=|Sf=lol- lol ]=tol- loll stole fe =Jol>[2[=]»lo)>[a] 2] fol>|2] x] ofo[> l=} | ofol>|a}=] olols lal ol elolstal ol solar Daily Private Car Meage [Gaiy Povate Car tieage (Day Pvate Cor Mieage, WAU! rt Bere [Diy Prvsto Car Wieage: Day Prato Car Mileage: WALLET Depart Aaive [Day Prat Car iieage: [Baiy Pruate Car ieage: "RALED Depa [Dai Prvste Car ties Day Private Car ties ele} elS|=[l-els flo] Teal Total Ene Oat 0.575 imi GRAND TOTALS >| efo|>[=] »] [o> [=] | =]o}= =] =] elal>: For CNTR 003 Reimbursement of Travel and Other Expenses Incurred in the Discharge of Ofcial Duy Four Sructure ast vise uy 2015 NC Deparment of Publ Safely. Division of Adinistration aaaNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED) IN THE DISCHARGE OF OFFICIAL DUTY [Payee's Work Phone Number 919.733.3873 oe Bivaion/Section Z Law Enforcement Division / State Highway Patrol et Tile 200 North Blount Stract Trooper Raleigh Normal Working Hous (roma) Pariod Coveree by ihe Request (worn) ‘Ciy, State, Zp) [Raleigh,NC 27601-1006, _ _ ‘Una praer ol pay cay Rs ws we aca Maa ie a ate _ [ens anes “anms aa aR Ta a AT PT eT sams na TBE eT Te ‘02. saree eit tst state CSITT [5 ie ‘003. 3 19:70 s}st2{rt2 L Ie Tel aleoley ‘ooo stole 00056 sts j 0008 [087 —- 1 (sits 7 Tatenne ET eae son as Advance 0.60, ANSeS, brreteed 4 WA Oo— ubaene? cond the actual eof departure and arival in blocks ind eu as Commasen Steers S00) yy 19 208 ‘SUBSISTENCE TeSteie | OF OFS ‘other Tawi Ex Explanation ‘Aout “TRANSPORTATION. TRAVEL (Show each Shy vated) Te-State | OuOFSiaie Da; Fon To Depart iaiy Prva Day Pv TAGE ‘Depart [aly Private Car mieage [Daiy Prvale Car Mileage TaATAS Depart Arve. [Daiy Prvate tar Oreoue [Daly Private Car Mieage 70.90 21.30 rilease, = 330] 7 7os0[¢ 230 la Tor SSE] Tar a0] 7 70.80 330m 0.575 rm fa Tome [5 Towa 7 0575 a 7080, GRAND TOTALS (>) Mog ot tava: P-Prvate Car” O= Other ra, bu, ee, parking fess = = (2 type oF Babar = Heusng (Room) Ulan 4 nous Reem Form CNTR 003 Reimbursement of Travel ané Other Expenses Incurted inthe Discharge of Oficial Duty Foon Stuctre last revsed July 2015, INC Department of Pubic Saety Division of Administration 7320. inate s1090 $1970 $5730 s930 $2130 S780 fads reams INOTE: Daiy efor subestenceNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Exccobve Detas| REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED - IN THE DISCHARGE OF OFFICIAL DUTY. (411 6308 Mie cca aera tara neem, Ha haan eGo on we er mpeg cos am Reg ry Oe a emt mes anna) corer yoc nomen Compan ek compa, oe a or qari tarcten revestntrs mca Ne cceseusaan ems eeu a Leta : SS Ee oo at re ce eee a Fo cardi eoremer pe See ‘sepa Ihave ven pr apo ovemgh Yoel ard so pesos ele ‘oor 0002 0008. 0008 0008: 0006. 00077 ‘0s 1008 Tl spe ne Loss Advance / Toe bow Owe) [E——W9 ‘Recor tn ate! tmeo oar and acai blk indeed Cea Asn Commision Spend Sap wes som TERE Gow chy ae]_[—— PRFORTATIN SORSETENCE Oar Tae pra Day T[inSaie— | On oS | 7] — sie | Ou OFS | —Betraton | Ara oA a ane Sepa t — aa 3 7 Sas Day Pate Certeage 030 ral F a Lea Gy Prt Cc Care Fate at 3H THs Toa Taras r = eee agar i t ss ee 3 n $30 Daye dtd n a Deira ortteags 0575 ml F aH FSH Tos — 7 : Das n t tee a n at Pe Careags ———G-TSTa ‘ lero [ny FrissGarnaseps———g_ 0375 ral oy Soi — OTOTALE TSS —— Fo a ToT a ripe aTaonemne Se moto rt ae Pca» Ob a pains ee Asa Rca Cen sav D-omer $1070 (NOTE: ony nr sunstrce Frounggteon) #0730 fastoceseunrend snort ovatus [omen rst re RECEIVED tenet $830 Cun Sieve soy ch 208 Dior atae nay 38 205 rng oom $7886 | Form CNTR 003 Reimbursement of Travel and Other Expenses Incued i the Discharge of Oficial Duy Re guennmensaas pec OCT 21 2015 NC Department of Public Safety, Division of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED eee IN THE DISCHARGE OF OFFICIAL DUTY Excuchve Sebi MI) be TNETRUCTIONS TOCLAMIANT utr ane ergnalto Genera AazauringAraeh alincessary orignal aap and fh: supporing Soeur oI fm Nous ay a teen approval exces epsaton ga, ah ol sstelcounty Wave. Ren one (1) cop er Your records. Compe son company, acount, 3 center fis, le ioet monn) ar not iater than 30 daye ser monn ens Prepare MeO Ye Payee's Work Prove Number Reimbursement for approved training expenses must be submitted to OSOT. ee 5. L38) —___—[Dvisoevsecton || — Te Tamer Payee's adsress (Steet) 12.20) [Normal Working ure Grom) ] Period Covered by mia Reaver (roma) "Unie pres open say as sue andacavale seat Sea ood GA BRITT TE F ‘gee tures ac sloweces reared tesa fh Sina theer ty Batey 5 Tolal Expense [$9500] — Tot Due (Owe) [¥ a605] L- > 8.12057 ne al \dgarture and arrival in blocks Coal Ash Commission Stpend Days. x8! c TRAVEL Show each ely vated) iher aval Exeraes Explanation [Amount SUBSISTENCE, Trsaie | Outcrsiat TRANSPORTATION Te-Siate | OuLOFS Day ais Depart ‘rive [Bay Private Car Mileage Dall Private Car leage ‘Bars Depar ‘Ave | — [Gaiy Private Car Mage [Day Prvete Car wieegs Bars la Tear [5 Total fads Towa Mise E035 Tl 0.575 mi GRAND TOTALS 370 2) Type ot Subs ly mode ot travet: [Promo Car O= Ones ral bus, the pring ees A=AK —- R=RenlaiCar rates $1090 5 -Cinner 31870 |NOTE: Day taal foreutesence HHeveng (Reem) $6730 roti exceed authorized ana out State cristae er ovotsiate tare 8 Brain sa CES 185 | Form CNTR 003 Reimbursement cf Travel and Other Expenses Incuted inthe Discharge of Offlal Duty Form Structure ist revised sly 2018 NC Department of Public Safety, Division of Adminisration REC'D AUG 12 2015TRAVEL Gh each chy aed FRANSPORTATION SUBSISTENCE ‘Gihar Wawel pers Da From: To Tn-Siale | OuOtSiae [2] —InSiaie [ Ou.OtSiate | —Faplanation | Amount NE] EE wos A [Day Private Car Wienoe. [Dany Prvate Car Wieage ais Depart [Day Private Gar tag wis Bete - Daly Fivaie Gar Miesge: Pruate Car Mieage: 7 la Tora fe Total PROSE ESSE E SOSSceSES Depa ‘ave Day Pate Carnage Daly Private Car Mia 7 Depa Arve. iy Private Car Mieage iy vate Gar Nea 2 Depart ‘Atv la Tovar [5 Towa Car age [Daly Private Car Wien 3 ‘Depart ‘rive [Day Private Car teage: [Daly Private Car Mieage = [2|- |=] Sf =[=[-[=[5]=[0)-|=|5}=lo1-|=|a}slol- elas olia 7 Depart Aue [Day Private Garin [Daly Private Car Micage: 7 Dasa ‘Aire [Daly Prvate Car wieage: 03 Tal [Daly Pruaie Car Mileage. 7 ia Tota 5 Tota Depa [Gay Private Carnie [Day Private Car Mion z Depa Ait Day Private Car Wage 0s Daily Private Cor Mea @ 0575 imi Total 5 Tela NSB 0 Form CNTR 003 Reimbursement of Travel ard Other Expenses incuted inthe Discharge of Official uty Form Structure last revised July 2015 NO Deparment of Public Safty, Division of Administrationerceennre Debe| REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED _| IN THE DISCHARGE OF OFFICIAL DUTY. [ANG>LS| NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY 4 not ater an 30 day ater rth ends a1e-7a5,3871 Reimbursement for approved taining expenses must be submited to OSOT. lonianiSecton — 1E Payee's Work Phone Number State Trooper Raich Period Covered by this Reauest (Fomioy |) — asi eats een ora sant md OT Payers AGdTess 200 Biount $1 ficiy, State, Zor Raleigh, NC. 27601 Tang Hoa (remo) Formal ANP 200115 Toate al ‘oor 0002 ‘D005; 004 Done 0006 ‘007 008 0009 — Tai Expena iio aesiech \ Peli Tot due (Owe) [Ewa] Pras Coal Ash Commission Stipend Era was TRAVEL Show oath cy ae) “TRANSPORTATION SUBSSTENGE area i fr[ isi ouorsiie [2] site [Ouse | —Enpinnon aT [5 6 = bapa <}$——Tes0 ots 1970 7 ‘Ais [Daly Private Can [aly Pate Gor tileage 12ers Depart [Daily Private Car Menge [Dany Prvate ci T2a7s Depart ‘airs Daly Pivate Car haleage— [Daiy Private Car tieage: 330 TIO, 70.30 @ 0575 0 230 70.90 78.70 EET 37 [5 Tora fate Total EE 0.575 ‘GRAND TOTALS (@) Type of Substance InSite B Breakast, $830 = otter rat bus. tas paring ees ASA R=RentalCar Letanen s1090 Dinner si (OTE: Dai os or suosnence H-Housng (Reem $6730 frotinexcaed autonzes aro urn state lorinstate or ofa rave H Housing (Reon) _$ 79 bn the Discharge of Official Duy n CNTR 008 Reimbursement of Travel and Other Expenses ncure Structure last revised July 2015 partment of Pube Sally, Dsion of Adminsiration‘ier Travel Expenses janaton | Amount SUBSISTENCE nSiaie | Ours F137 32 TRANSFORTATION, TRAVEL how each Gy VETS) ThSe | OLS From To oT z By ED ae i Beve [Daty Private Car Mieoge [Dmiy Prvate Cor Mie 33] fetve [Bay Private Owe [Dat Private Cor Mioge: 3 030 0575 3} Depa Bite [Day Private Ca ie: [Dany Prva car wieage (@ 0875 mi 2 i Depa ‘Ave . Daly Priaie Car wiage ly Payate Car Mi iaToar 5 Tout 3 Prva Car wibage Private Cor Nea 3] Depa ‘Aare [Daly Pre Car eeage [Diy Fruste Cor tengo 7 3 =| =|o}>[=] ol wfo}>|=] =] ]o}> 2] »] »)ol>[=] >] =[o]>[=] «| =[o|> l=} =| slol>iatal slolstal lala talal olotstat Depa Prva Car Wenge Prva Cor Mieoge: (a [ba Depa ‘Ate Baty Prvaie Carmaage: iy Private Car henge aa oe ay Pre Car wreage ay Prva Car Mle fel lola lel- lel} felled stot tala)slol-lolstatoltel Dagar Bare ny Private Car [Day Private Car ia 7 are aly Private Car oage Daily Privaie Cr witeoge: 2 [arom D575 i [stom Depart are vd Car age Day Private Car tea 730 0.575 imi GRAND TOTALS 0 Form CNTR 003 Reimbursement of Travel and Other Expenses Incurad in he Discharge of Official Duy Form Sct last vised Juy 2015. INC Deparment of Pubic Safely, Divsion of AdminstrationTUIM NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED INTHE DISCHARGE OF OFFICIAL DUTY. (4136s al necessary cignalrecebs ard che eupporing doses Whe frm, dan no *) ony or yur toot Compl amount samba, acount ard cn ston goon al excess regs [Payews Work Prone Number 979.735.3871 ]_//_ Reimbursement or approvestralning expanses must be submit to OSOT. paras iene _\___ ffiaw Enforcement Division State Highway Patrol EP te [00N aunt Sh ctae Tnoper _ cy. Sta Zp) FRormal Werke Hours toni) Parod Covered ty tia Rea [alegn,NC27603, rane, : oe 72a se EREEE i $a cae REGRE shel s = Stsl2t7iety LZ TT fet $F Bt + — a ri san} = (EEC tot Bue (Owe) LE 7atelle Coal Ash Commission Stipend city ss $0.00 TRAVEL Show each oy wate TRANSPORTATION, From To TrSisle | Ou OT Ste SUSSISTENCE. TeSiale | OnSite ior Tara pena Beianaion | Anouit oi Ta te ay Bi z Tea. = a t arn ‘Daly Pin [Daly Private T25T6 a (Bay Privaie Cr tes [Baty Prvaie Car Mleage: lease Gr Nileoge 2030 /m 0575 in 5 Tovar i @ 030 7a 7375 7m in Taar Taal one GRAND TOTALS “520 RES Tom SE Bp Ti Trova Subsisioce: nS PPro Car "= Ofer ra. tus a parknglees — AAr — R=RertalCar turen sioso 51870 |yoTe: Oaiy wiser sutuence RECEIVED WL 29.08 Too ~ for sat oc soe vave | Onna $2130 | Ferm CNTR 003 Reimbursement of Travel and Othor Expenses Incurred in he Discharge of Otel Duty Form Structure ist revised July 2018 [NE Deparment of Pus Satety, Divison of Administration2B 7 NORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED INTHE DISCHARGE OF OFFICIAL DUTY 4a INSTRUCTIONS To GLAMIANT” Gol cw= orga coal Arconing_Atach alinecesay orginal ens ass er apantng acu 6 Hs orm salen, sang orc at cease tay ton on) copy yu Yecrs Complete wrod cama, Ist ono an proved usining expenses must be submited to OSDT. Foxes ian one tunier ‘919755871 Reimbursement Tatar Lad IDvsonsecion Low entercoment Division Stats Highway Patol E> ite 200N Blown site Trooper align — Cr, Sia, 2 oar ering Fou rontoy Perk Covered ty Ws Regia eign NC 27601 frais ren ean Fe (Woes inew panpar povatr negitont on ee ponouihce 2-85 -SO ‘Serta Telephone # 007 002 03 on 0008 2008 ‘007 canbe Toil Exper Less Advance Tot Due (Owe) Coat sn Comission Stipend ie —— : — = : : s : aaa Pt ee AS coat nenoRECE WEB | fu im | JUL 29 206 dizegrat we fonenenencee | Noss Room) _$ 7850 Form CNTR 003 Reimbursement of Travel and Other Expenses inured inthe Discharge of Offi Duy Form Stacie la reed July 2015 NC Dapariment of Pus Safely, Dvsion of AcminisiratonNORTH CAROLINA DEPARTMENI OF FUBLIL SArErT REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY (AULU3 0S SCANT Sime Gof exces reptrton lodgng. 2 Fava rot ater tan 30 days ant month ends. Prepore ink ot pe 19-733-30 Reimbursement for approved training expenses must be submited to OSDT. DvieanvSecton ] a [200 N_ Blount St State To9per (cry, State, Zn) ‘Normal Wercng Woure (rama) [Ferd Covered by ts Request (ramy Raleigh, NC-27601 [ratte ane a186 nd ce cin Sm hr coy revs aries prsra ee, eae’ 4201 (Date) P; AID — way 04 206 ae Live Wo. wun coupany. account ‘007 o02 0005, Te Tato T aa IN | 004 nos t 006 | 007 a +t t fr) 008 Eee I 1 Tol Expense [$678 - ~ 52 Toss Advnce Tot Due (Owe) 7 A/eu/ tle od th acu in of dopa and ava in Hocks idea ‘Coal Ash Commission Steend #Oaye sis = c TRAVEL Siow no ay vies] ‘iar Travel Expenses Explanation | Amour SUBSISTEN Saale —TRANGE in Sate ORTATION, Out OuDeSate 750 1870 Be 330 [Daly Prvaie Car Mieage Daly Private Car Micage TAT Depa. Daily Pvaie Car Meage: Daly Prvate Car tieage lator fs Total aes Tortie 2 020m ‘GRAND TOTALS ee | 3 | \t) Mode of Travel: [Pile Car 0 Omer a, bus. ‘aw. parking evs Offical Duy Form CNTR 003 Reimbursement of Travel and Other Expenses incuredin the Dischay Form Structure inet evieed Jay 2015. [NC Department of Pubic Safely, Division of AdminstrationGiher Tavel Expenses Exploration | AmoURT SUBSISTENCE, estate| Out OFSite 730 a0 TRANSPORTATION inStole | Out OF Stale Parana pes en or z = ra car waeage Prec FIT 5 a Dy Private Carpe 050m (ba Private Car Monge 2006 Depa oars Daly Private Carmaage aay Prive Co a6 Depart Aire Prva Car ERG ay Private Ca aaa Depart eve Day rie Carnage: a Dats Private C aaa Depart ve (aiy Private Caren @ Baty Privie Car Mileage TUTE Depart ae ay nate Cor Meage PEE [Dan Prvate e576 Depart Daly Private Caren Dai Private Car Mean: @ 0875 a6 a ‘Aes Dany Private CarTmeape Daily Private Car Mieone aero Depart Ae Day Private Carag [Doi rate aT [Depart rive [Diy vate Cornaeage e030 Ta Day Private Ci ae Depart Atv i vse Ca aS la Total 5 Tota 1a Tor 15 Torah la Tovar [5 Total la Tota 5 Total Total 5 Tota ia Tor 5. Total Tovar Tora la Tatar is Total S030 Private Car Mieage 0.575 ‘ni ‘GRAND TOTALS fats Tom se Fy Form CNTR 003 Reimbursement of Travel and Other Expenses Incured inte Discharge of Oficial Duty For Structure last revised July 2015 a INC Department of Pubic Safety, Civison of AdministrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL. DUTY [4 GBS” TNSTRUCTIONS TO GLAMANT” Subm¥ow ongvalto Gena Accnuring Atach a necessayorpna ees and Oe’ supp docu tec anznl ct asain sg. travel Feta oe (1) copy "you eords Comps moan com = mo] 37 1 |Dvween/Secton |tow enforcement Division / State Highway Patrol Er Reimbursement for ve rong expenses must be submited to OSDT. Pevnd Covered by tha Pamiem oma) 456 sii ora see ae sai rotor Vib "Siber sot Teenie Tate estes Taal capanea 1S Lese Advance Tot. Due (Owe) Record the actual ti Coa en Commission Stipe #Daye ysis = TRAVEL Show cach oy va Day Private Car Miaaae [Taar Dany Prva is Tota [Baty Pavate Car heave, [stow ———| GRAND TOTALS | es Tora ae std of Tava Resear k A PT ep som RECEIygp9190¥ N39 NI0.938 2 sae | ae | PE Ee | Feim CNTR 003 Reimbursom: Fim Siurcture last revised July 2 NC Deparimert of Pubic Sate the Expenses Inu in tho Discherge of Oficial DuyTRAVEL how each oy waNea) TRANSPORTATION Arve “TOTALS BROUGHT FORWARD |_| 3__ aa ® T els 6.30 T oa bas : sf ae at [Day Prvaie Car Waeage Ta [Dety Private Corto T575 rm eae Seo | ‘Ave 1 Dany Pate Corteage: 030m [Day Povate Car Mieage: “575 ad Depart Say Pine Coreage 9-03 | = : aa ————— Depa —Tat tL T ara csrmege———g-a30-m — = teat Day Prvate Car toage. Depa [Daiy Prvate Car micage: a0 [a Toa_ [Day Privat Bars Bia Depa Day Private Car iteage: 3H Se 0505 Depa ace [Baiy Private Carma Co mal [Doty Private Car Mileage: 575 ml Fem CNTR 003 Reimbursement of Travel rd Other Expenses incur inthe Dischsrge ot Otol Day Form Stic last revised July 2015 INC Depaciment of Pub Sate, Division of AériistratonNORTH CAKULINA DEFARIMEN! Ur ruDLIL onrers REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED a FIIs IN THE DISCHARGE OF OFFICIAL DUTY [Garces Work Phone Number 919.735.3871 Reimbursement for approved training expenses must be submited to OSOT. je mina Lash IoivaoniSecton 7 Law Enfore Statn Highoray Patrol EPO ie fa Number [Raleigh INocmal Working Hours (remney [Peed Covered by Tis Request (omy act _ 34 ‘Supenisor Telephone #) peo ee es = sro] T [FTO Ti slalei7ieta rT T rae ir Z si3l2 Total Expense HD Somer Less Advance a . Taboo) [aa] [ 3lerl!© inl cord th Coal Aah Commiasion Stipend Days KSI5 = $9.00 “TRAVEL Grow each ay val — TRANSPORTATION Fao 7 Tnsite | Ou-OrSiae ‘Giher Travel Beraes — Expianaion [amount SUBSISTENCE, TrSate | OurSrStaie EC] 70-90 1870 nae Depart — [Daly Private Car ntieage: Daly Prvate Car Mien wis Depart ‘Aare Daly Private Car Meese [Day Private Car Mieage: GTS Depa [Day Private Car Wage ia Towa 5 Toial a 230 7090 @ 0575 im} 0) fs Tova z 3. 3 = ©. Osa P Dany Piva Cortmease Tae TRAD TOTALS 0 fre Ta CS ypeat Sones Se ode ot rave 2 beat arse Pome Oe OMe OE RECEIVED “Shame oe tia7e font Onn sre ‘ owes fernceatwraserone iret MAR 2.9 2016 B- Breakfast $820 Nc DPS Accounting O-ommee $2130 l 1g ey Form CNTR 003 Rembursement of Travel and Other Expenses Incurred inthe Discharge of Ofcal Duty Form Structure ast evised July 2015, NC Department of Pube Salely, Divsion of AdminstrationNORTH CAROLINA DEPARTMENT OF PUBLIC SAFETY Sxec-nbae. PraveTn> REIMBURSEMENT OF TRAVEL AND OTHER EXPENSES INCURRED IN THE DISCHARGE OF OFFICIAL DUTY 14116365" supparing ocimans fs rm, nausig ary pdlfant Sumitore sia tc Garwat Acsouning. Ath alinecessay orga recaps and ee raven gna ar oo obeartuet av Rela oe (1 cop) your cans Comptes amps, GE iter inan 0 bay 1s meth oe. Propare ine Yee we Reimbursement for approved waning expenses must be submited to OSOT. IBison/Section Law Enforcamant Division | State Highway Patri ERD. apb Work Prone Number Payee adetess OF ber 901 Blount St ak “ (iy. Stato Zp) Peiod Covered by tis Request (Fomva) [razigh, NC-27601 : 2058 zens | Tae Res Rn ta CRY RTS Pa OTH 218/16 ‘0001 z = Spare Cot ss ‘O00 370] TIA DTT ststep rere Ct eT cant ——T¥ zi ststetatepet tp 4 ‘oe : stale ‘os ——T$ =F eres O08 = g Jan oes Advance Tec Due ee) apulty Coal Ash Commission Stpend fon mss = 5000 TRAVEL Saw osc va) "RANSPORTATION SUSISTERCE [onal Enso Da T[—issae | outers | 7] esate Siena ATT 276 i n Depa z + = ae 3 0} $7878 [asp Private fp i Iran =| Day Private Cor ong 3875 ml oS a7] I Tos eT = ={s = = Dogar = Ht - a = > te Daly Prat Car Mage 090 inl» =F i lero iy vate Car cape @ 0575 inl P a 30 5 Toa Prin = a Separ * t == we 3 — ay vate Car Rage oar F i lero Daiy Private Car nage: 90375 mil F 7 To GRAND TOTALS =a pane Ta EE Gi ypear subside in sate mode of rat @-Baa aaa0 JPrPrt Car 0 other, us. te aig ttt soso RECEIVED Bat at ore Fchouang Reon) 97.30 ftlomeeed eunread nest JAN 2.4 vib B Bradast so0 ttn Soe 3 omer ae _ Rowan Room) $7250 id Cher Expenses Incurred in the Discharge of Official Duly FEB IT 2016 ‘orm CNTR 003 Remouesemant of Teavel Foe Structure est evised July 2018 INC Department of Pubic Safty, Division of Administration Secon ey