AMERICAN POSTAL WORKERS UNION, AFL-CIO EXPENSE VOUCHER FOR DESIGNATED REPRESENTATIVES/COMMITTEE MEMBERS (Updated January 3, 2020) ATTACH ALL ORIGINAL RECEIPTS TO A SEPARATE SHEET OF PAPER NAME: LAST 4 DIGITS OF SS#: E-MAIL ADDRESS: HOME ADDRESS: CHANGE OF ADDRESS STREET PHONE #: CITY STATE CENTRAL REGIONAL AUTHORIZATION EASTERN NORTHEAST SOUTHERN WESTERN ZIP CODE OTHER: DATES: LOCATION ADDRESS: AUTHORIZED BY: DESCRIBE IN DETAIL: NATIONAL AUTHORIZATION CLK MNT MVS ASSIGNMENT INFORMATION FROM TO NAME OF INDIVIDUAL SAFETY & HLTH NON-ARBITRATION ASSIGNMENT BMC L\M MTG STEP 3 TRAINING POWER OTHER: CLUW BPI MAINT STAFFING RI 399 ARBITRATION ASSIGNMENT YES NO ARBITRATION CASE NO: HEARING: CANCEL: PRE ARB: CASE # MANDATORY FOR REIMBURSEMENT OF ARB PREP &/OR HEARING EXPENSE DETAILS ON BACK NAME: LODGING: AMERICAN POSTAL WORKERS UNION, AFL-CIO EXPENSE VOUCHER FOR DESIGNATED REPRESENTATIVES/ COMMITTEE MEMBERS EXPENSE DETAIL ORIGINAL RECEIPTS REQUIRED # OF NIGHTS: @ PER NIGHT ROOM & TAX HOTEL MEALS: (ITEMIZED RECEIPTS REQUIRED) HOTEL TELEPHONE CHARGES: OTHER HOTEL CHARGES: (EXPLAIN) 1/3/2020 MEALS: MEAL EXPENSES (ITEMIZED RECEIPTS REQUIRED) TRANSPORTATION: * FROM: TO: LODGING TOTAL TOTAL ALL AIRFARE AND AIREFARE EXCHANGE FEES ARE DONE THROUGH THE AXIOM TRAVEL MASTER ACCOUNT PARKING: CABS: RENTAL CAR : PERSONAL AUTO: ******Cost comparison required if driving more than 4 hrs each way ******Complete addresses required for mileage reimbursement # OF MILES: MISCELLANEOUS EXPENSES: TIPS: SKYCAP: HOUSEKEEPER: OTHER: EXPLANATION CAB: VALET: 0 @57.5 cents/mile (Effective 1/1/20) TOTAL TRANSPORTATION EXPENSE GROSS TOTAL ARBITRATION ASSIGNMENT - COMPENSATION PREP DATE (S): HEARING DATE (S): NUMBER OF HOURS: @ 39.9362 (EFFECTIVE 8/29/2020) GROSS TOTAL NON-ARBITRATION ASSIGNMENT - COMPENSATION BEGIN DATE: USPS LEVEL/STEP: END DATE: NUMBER OF HOURS REGULAR: NUMBER OF HOURS NIGHT DIFFERENTIAL : NUMBER OF HOURS SUNDAY PREMIUM : @ PER HOUR @ PER HOUR @ PER HOUR GROSS TOTAL EXPENSES & COMPENSATION - GRAND TOTAL Name: Trip Dates: Location: From: To: American Postal Workers Union, AFL-CIO Mileage Log Date Purpose From (complete address required) Street City State Zip To (complete address required) Odometer Total mileage Reimbursable amount Street City State Zip Start Finish Signature: TOTAL MILEAGE REIMBURSEMENT I hereby certify that the above is a true statement of travel expenses incurred by me. Date:Acrobat Distiller 15.0 (Windows)