DJJ Form DFS-AA-13 Appendix A "Authorization to Incur Travel Expense" - Florida

What Is DJJ Form DFS-AA-13 Appendix A?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.The document is a supplement to DJJ Form DFS-AA-13, Authorization to Incur Travel Expense. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 4, 2015;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DJJ Form DFS-AA-13 Appendix A by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download DJJ Form DFS-AA-13 Appendix A "Authorization to Incur Travel Expense" - Florida

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FDJJ 1407.01
Appendix A
Revised 3/4/15
APPENDIX A
AUTHORIZATION TO INCUR TRAVEL EXPENSE
FORM DFS-AA-13
(formerly FORM C-676C)
Instructions for completion of the Authorization to Incur Travel Expense, Form DBF-AA-13 are given
below. Numbers 1 through 53 correspond to the attached facsimile (page three of this appendix).
Blank #
Instructions
(1)
Name - Name of the traveler.
Official Headquarters - City or town of traveler’s official headquarters.
(2)
(3)
Date - Date the Form DFS-AA-13 is prepared.
Division – Administrative Services, Detention, Prevention & Victim Services, Probation,
(4)
Residential Services
Purpose of Trip – Indicate the purpose of trip, title of conference or convention to be attended
(5)
etc., keeping in mind current travel restrictions.
Number of Employees in Authorization – Enter the number of employees included in this
(6)
authorization.
(7)
Destination - Indicate destination.
Travel: Explanation/Justification of Mission Critical Travel – Provide
(8)
explanation/justification that requested travel is in keeping with the Department’s critical
mission(s)
Departure Date – Enter date of departure (M/D/YY).
(9)
Return Date – Enter date of return (M/D/YY)
(10)
Total Days – Enter total travel days based on departure and return.
(11)
(12)
Departure Time - Enter time of departure (H:MM am or pm).
(13)
Return Time - Enter time of return (H:MM am or pm).
Trip Number – If assigned, enter trip number.
(14)
Travel to be Paid by State/Grant/Other – Check appropriate box regarding funding source for
(15)
travel. If grant funded, provide grant name or number.
(16)
Total Estimated Per Diem - Estimate the cost for per diem or lodging and meals.
Registration Fee – Enter registration fee if requesting attendance at conference or convention.
(17)
Car/Vehicle Used – Select and check the appropriate box regarding type of vehicle to be used.
(18)
Estimated Miles Driven – Enter the total estimated number of miles the state vehicle will be
(19)
driven.
Mileage Rate – Estimated mileage rate for state vehicles. Read Only Field
(20)
Total Vehicle Cost – “Estimated Total Miles Driven” X “Mileage Rate” (automatically
(21)
calculated in the PDF version of form).
Daily Rental Rate for Class – Enter the state contract daily rental rate for the class of the
(22)
rental vehicle.
Days Rented or Driven – Enter the number of days the rental vehicle is to be rented.
(23)
FDJJ 1407.01
Appendix A
Revised 3/4/15
APPENDIX A
AUTHORIZATION TO INCUR TRAVEL EXPENSE
FORM DFS-AA-13
(formerly FORM C-676C)
Instructions for completion of the Authorization to Incur Travel Expense, Form DBF-AA-13 are given
below. Numbers 1 through 53 correspond to the attached facsimile (page three of this appendix).
Blank #
Instructions
(1)
Name - Name of the traveler.
Official Headquarters - City or town of traveler’s official headquarters.
(2)
(3)
Date - Date the Form DFS-AA-13 is prepared.
Division – Administrative Services, Detention, Prevention & Victim Services, Probation,
(4)
Residential Services
Purpose of Trip – Indicate the purpose of trip, title of conference or convention to be attended
(5)
etc., keeping in mind current travel restrictions.
Number of Employees in Authorization – Enter the number of employees included in this
(6)
authorization.
(7)
Destination - Indicate destination.
Travel: Explanation/Justification of Mission Critical Travel – Provide
(8)
explanation/justification that requested travel is in keeping with the Department’s critical
mission(s)
Departure Date – Enter date of departure (M/D/YY).
(9)
Return Date – Enter date of return (M/D/YY)
(10)
Total Days – Enter total travel days based on departure and return.
(11)
(12)
Departure Time - Enter time of departure (H:MM am or pm).
(13)
Return Time - Enter time of return (H:MM am or pm).
Trip Number – If assigned, enter trip number.
(14)
Travel to be Paid by State/Grant/Other – Check appropriate box regarding funding source for
(15)
travel. If grant funded, provide grant name or number.
(16)
Total Estimated Per Diem - Estimate the cost for per diem or lodging and meals.
Registration Fee – Enter registration fee if requesting attendance at conference or convention.
(17)
Car/Vehicle Used – Select and check the appropriate box regarding type of vehicle to be used.
(18)
Estimated Miles Driven – Enter the total estimated number of miles the state vehicle will be
(19)
driven.
Mileage Rate – Estimated mileage rate for state vehicles. Read Only Field
(20)
Total Vehicle Cost – “Estimated Total Miles Driven” X “Mileage Rate” (automatically
(21)
calculated in the PDF version of form).
Daily Rental Rate for Class – Enter the state contract daily rental rate for the class of the
(22)
rental vehicle.
Days Rented or Driven – Enter the number of days the rental vehicle is to be rented.
(23)
FDJJ 1407.01
Appendix A
Revised 3/4/15
Total Estimated Miles Driven – Enter the total estimated number of miles the rental vehicle
(24)
will be driven.
Mileage Rate – Estimated mileage rate for rental vehicles. Read Only Field
(25)
Total Vehicle Cost – “Daily Rental Rate for Class” X “Days Rented” X “Estimated Miles
(26)
Driven” X “Mileage Rate” (automatically calculated in the PDF version of form).
Total Estimated Miles Driven – Enter the total estimated number of miles the personal vehicle
(27)
will be driven.
Mileage Rate – Mileage rate for use of personnel vehicles. Read Only Field
(28)
Total Vehicle Cost – “Estimated Total Miles Driven” X “Mileage Rate” (automatically
(29)
calculated in the PDF version of form).
Hotel – Enter the name of the hotel for the person requesting authorization to travel.
(30)
(31)
Confirmation# - Enter the confirmation number for the hotel.
(32)
Rate - Enter the hotel rate for this request.
(33)
Nights - Enter the number of nights the traveler is staying in the hotel.
Cost - Hotel cost calculated based on “Rate” X “Nights” (automatically calculated in the PDF
(34)
version of form).
(35)
Airline - Enter the name of the airline for the person requesting authorization to travel.
(36)
Departure Flight - Enter departure flight number information.
(37)
Time - Enter the flight departure time (H:MM am or pm) for this request.
(38)
Return Flight - Enter return flight number information.
(39)
Time - Enter the flight return time (H:MM am or pm) for this request.
(40)
Cost - Enter the cost for airline tickets.
Total Estimated Cost for Trip – Sum of “Total Estimated Per Diem” + “Registration Fee” +
(41)
“Total Vehicle Cost” (either state, rental or personal vehicle) + “Hotel Cost” + “Airline”
(automatically calculated in the PDF version of form).
(42)
Comments - Provide any additional comments regarding this request, including an
explanation if no cost is to be incurred in any of the travel expense categories.
Signature – Signature of Traveler certifying that the main purpose of the travel shown is in
(43)
connection with official business of the state.
(44)
Approved by Supervisor - Signature of Supervisor or person with delegated authority to
authorize travel.
Date – Date Supervisor approved travel request (M/D/YY).
(45)
(46)
Approved by Deputy Secretary or Chief of Staff - Signature of Deputy Secretary or Chief of
Staff approving travel.
Date – Date Deputy Secretary or Chief of Staff approved travel request (M/D/YY).
(47)
(48)
Approved Agency Head - Signature of Secretary approving travel request.
Date – Date Secretary approved travel request (M/D/YY).
(49)
Approved Executive Office of Governor – Check box approval (Yes or No) and Signature of
(50)
Executive Office of Governor approving travel request.
Date – Date Executive Office of Governor approved travel request (M/D/YY).
(51)
FDJJ 1407.01
Appendix A
Revised 3/4/15
DEPARTMENT OF JUVENILE JUSTICE
State of Florida
AUTHORIZATION TO INCUR TRAVEL EXPENSE
State of Florida
Name:
Official Headquarters:
Date:
Authorization to Incur
(1)
(2)
(3)
Travel Expenses
Division:
(4)
Department: Department of Juvenile Justice
Purpose of Trip:
Departure Date
Return Date
Total Days
(5)
(9)
(10)
(11)
Number of Employees
(6)
in Authorization
Destination:
(7)
Travel: Explanation/Justification of Mission Critical Travel
Departure Time
Return Time
Trip Number
(8)
(12)
(13)
(14)
Travel to be paid by
State,
Grant
(15)
(name or number of grant) or
Other.
Total Estimated Per Diem:
(16)
Registration Fee:
(17)
Car/Vehicle Used:
Daily Rental Rate for Class
Days Rented or Driven
Est. Total Miles
Mileage Rate
Total Vehicle Cost
Driven
(18)
(19)
$0.19
(20)
(21)
State Vehicle
(22)
(23)
(24)
$0.19
(25)
(26)
Rental Vehicle
(27)
$0.445
(28)
(29)
Personal Vehicle
Hotel:
Confirmation #
Rate
Nights
Cost
(30)
(31)
(32)
(33)
(34)
Airline:
Departure Flight
Time
Return Flight
Time
Cost
(35)
(36)
(37)
(38)
(39)
(40)
TOTAL ESTIMATED COST FOR TRIP:
(41)
Comments: If a cost is not incurred for one of the above travel expense categories, please provide an explanation (for example, no hotel expense –
Traveler is staying with family or friends, or no per diem being requested by Traveler).
(42)
EstMiles1
I hereby certify that travel as shown above is to be incurred in connection with official business of the State
Signature:
Approved by Supervisor:
Date
Approved by Deputy Secretary/Chief of Staff:
Date
(43)
(44)
(45)
(46)
(47)
Approved – Agency Head:
Approved – Executive Office of Governor
Date
Yes
No
Date
(48)
(50)
(51)
(49)
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