Section J 3C Form CSO010 Court Security Officer Travel Authorization.pdf

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Form CSO-010 Rev. 08/19 Page of

UNCLASSIFIED // FOUO

Note: Completed forms containing personally identifiable information (PII) must be encrypted and include the appropriate marking (U/FOUO) in the SUBJECT line of the message prior to dissemination via email.

UNCLASSIFIED // FOUO

U.S. Department of Justice United States Marshals Service Court Security Officer Travel Authorization INSTRUCTIONS: Complete and submit Form CSO-010 to the appropriate supervisor for approval PRIOR to traveling.

1. VOUCHER:

Voucher Type:

2. TRAVELER IDENTIFICATION

3. ITINERARY

4. ESTIMATE OF TRAVEL COSTS

Estimated Costs:

5. PURPOSE OF TRAVEL

6. TRAVEL CONDITIONS / LIMITATIONS

Mode of Transportation Authorized (Select all that apply):

List current (i.e., train, bus) that does not exceed the cost of common carrier)

7. MODE OF SUBSISTENCE AUTHORIZED (If applicable, enter the rate per day):

per day.

(Requires approval by appropriate official.)

8. CONTRACTOR'S REVIEWING OFFICIAL APPROVAL

Approving Official Certification: You are authorized to travel at government expense in accordance with Department of Justice regulations under the conditions outlined in this authorization as necessary for the conduct of United States Marshals Service business relative to the applicable USMS Court Security Service contract.

9. CONTRACTOR OFFICER'S REPRESENTATIVE APPROVAL

Privacy Act Statement: Solicitation of the information on this form is authorized by 5 U.S.C. Chapter 57 as implemented by the Federal Travel Regulations (FTR) 41 C.F.R. Chapters 300 to 304 (January 2004), as amended. The primary purpose of the requested information is to determine payment or reimbursement to eligible individuals for allowable travel and/or other expenses incurred under appropriate administrative authorization and to record and maintain costs of such reimbursements to the Government. The information will be used by Federal agency officers and employees who have a need for the information in the performance of their official duties. The information may be disclosed to appropriate Federal, State, local, or foreign agencies, when relevant to civil, criminal, or regulatory investigations or prosecutions, or when pursuant to a requirement by this agency in connection with the hiring or firing of an employee or contract employee the issuance of a security clearance, or in connection with investigations in the performance of official duty on behalf of the Government. Your Social Security number (SSN) is solicited under the authority of the Internal Revenue Code (26 U.S.C. 6011(b) and 6109) and E.O. 9397, November 22, 1943, for use as a taxpayer and/or employee identification number; disclosure is MANDATORY on vouchers claiming payment or reimbursement which is, or may be, taxable income. Disclosure of your SSN and other requested information is voluntary in all other instances; however, failure to provide the information (other than SSN) required to support the claim may result in delay or loss of reimbursement for travel expenses.

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