Att_5_Travel Authorization Form.pdf

CLIN Sponsor Sub-CLIN

EMPLOYEE NAME:

COMPANY*:

CONTRACT:

SUPPORTED PMO:

ORGANIZATION TO BE VISITED:

PURPOSE:

DATE PREPARED:

ORIGIN LOCATION:

DESTINATION LOCATION(S):

DEPARTURE DATE:

RETURN DATE:

TOTAL COST:

TYPE OF EXPENSE # OF DAYS SUB-TOTAL

SUPPORTED PMO LEAD:

JPO TRAVEL APPROVER**:

JPO COR:

TRIP REPORT REQUIRED:

DM# 218632

JPO CONTRACTOR TRAVEL AUTHORIZATION REQUEST FORM

PER DIEM RATE / DAILY EXPENSEDESCRIPTION

ADDITIONAL NOTES:

TRAVEL AUTHORIZATION NUMBER

PROVIDE JUSTIFICATION THAT ALTERNATE MEANS, SUCH AS SECURE VIDEO TELECONFERENCING (SVTC) OR OTHER WEB-BASED COMMUNICATION, ARE NOT SUFFICIENTLY ABLE TO ACCOMPLISH TRAVEL OBJECTIVES

Updated: 4.20.2020

* I certify that the travel contemplated within this request is in accordance with all current Federal Travel Regulations (FTR); as outlined in the Code of Federal Regulations (CFR). If for some reason, the travel authorization request is not in compliance with the current regulations due to strategic or operational necessity that fits within an approved waiver category it shall be properly indicated to the government approving official when submitted for review and approval.

** Refer to DM# 377581 for updated list of JPO Travel Approvers. Account for all expected travel expenses on tis travel request form. This is your estimate cost for government approval. You are required to verify the current Per Diem rates prior to your authorized travel.

If Other, specify

$ 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00

$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00

USG

YES NO

Other