DJJ Form FA001 "Voucher for Reimbursement of Travel Expenses out of State" - Florida

What Is DJJ Form FA001?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 26, 2007;
  • 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 fillable version of DJJ Form FA001 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 FA001 "Voucher for Reimbursement of Travel Expenses out of State" - Florida

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TRAVELER
PEOPLE FIRST ID##
STATE OF FLORIDA
WORK ADDRESS
HQ CITY
CIR #
VOUCHER FOR REIMBURSEMENT
CITY, STATE, ZIP CODE
RESIDENCE (CITY)
OF TRAVEL EXPENSES
Department of Juvenile Justice
Check One:
Employee
OPS
Nonemployee/Ind. Contractor
Hour of
Class
Actual
Per
Class C
Map
Vicinity
Incidental Expenses
Travel Performed From
Purpose or Reason
Depart &
A and B
Lodging
Diem
Meals
Mileage
Mileage
Date
Point of Origin to Destination
(Name of Conference)
Return
Meals
Expenses
Claimed
Claimed
Amount
Type
Amount
Air Fare
SUBTOTAL PAGE 1
$0.00
$0.00
$0.00
0
0
$0.00
$0.00
$0.00
SUBTOTAL PAGE 3
$0.00
$0.00
$0.00
0
0
$0.00
Column
Column
Column
Column
Column
0
Miles
Column
ORG CODE
EO
Total
Total
Total
Total
Total
Total
@ $.445/Mile
INVOICE#
$0.00
$0.00
$0.00
$0.00
OBJECT
AMOUNT
OBJECT
AMOUNT
$0.00
$0.00
TRAN. DATE
$0.00
262000
262400
$0.00
SUMMARY Total
$0.00
262100
$0.00
262500
$0.00
LESS CLASS C MEALS (EMPLOYEE/OPS ONLY)
)
(
$0.00
LESS NON-REIMBURSABLE ITEMS ON PURCHASING CARD
262200
$0.00
)
LESS TRAVEL ADVANCE
(
262300
$0.00
Advance:
Revolving Fund:
NET AMOUNT DUE - TRAVELER
$0.00
Warrant No.
Check No.
NET AMOUNT DUE TO STATE
$0.00
Warrant Date
Check Date
Statewide Doc. Date
Agency Voucher
Pursuant to Section 112.061(3)(a), Florida Statutes, I hereby certify or affirm that to the best of m y knowledge the above travel was on official
business of the State of Florida and was performed for the purpose(s) stated above.
Agency Voucher No.
$0.00
Supervisor's Signature
I hereby certify or affirm that the above expenses were actually incurred by me as necessary travel expenses in the performance of m y official duties;
attendance at a conference or convention was directly related to official duties of the agency; any meals or lodging included in a conference or convention
Signature Date
registration fee have been deducted from this travel claim; and that this claim is true and correct in every material matter and same conforms in every respect
with the requirements of Section 112.061, Florida Statutes.
Supervisor's Title
Traveler's Signature
Prepared By
Signature Date:
Title:
Phone\Suncom Number
\
FA001
Revised 01/26/07
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TRAVELER
PEOPLE FIRST ID##
STATE OF FLORIDA
WORK ADDRESS
HQ CITY
CIR #
VOUCHER FOR REIMBURSEMENT
CITY, STATE, ZIP CODE
RESIDENCE (CITY)
OF TRAVEL EXPENSES
Department of Juvenile Justice
Check One:
Employee
OPS
Nonemployee/Ind. Contractor
Hour of
Class
Actual
Per
Class C
Map
Vicinity
Incidental Expenses
Travel Performed From
Purpose or Reason
Depart &
A and B
Lodging
Diem
Meals
Mileage
Mileage
Date
Point of Origin to Destination
(Name of Conference)
Return
Meals
Expenses
Claimed
Claimed
Amount
Type
Amount
Air Fare
SUBTOTAL PAGE 1
$0.00
$0.00
$0.00
0
0
$0.00
$0.00
$0.00
SUBTOTAL PAGE 3
$0.00
$0.00
$0.00
0
0
$0.00
Column
Column
Column
Column
Column
0
Miles
Column
ORG CODE
EO
Total
Total
Total
Total
Total
Total
@ $.445/Mile
INVOICE#
$0.00
$0.00
$0.00
$0.00
OBJECT
AMOUNT
OBJECT
AMOUNT
$0.00
$0.00
TRAN. DATE
$0.00
262000
262400
$0.00
SUMMARY Total
$0.00
262100
$0.00
262500
$0.00
LESS CLASS C MEALS (EMPLOYEE/OPS ONLY)
)
(
$0.00
LESS NON-REIMBURSABLE ITEMS ON PURCHASING CARD
262200
$0.00
)
LESS TRAVEL ADVANCE
(
262300
$0.00
Advance:
Revolving Fund:
NET AMOUNT DUE - TRAVELER
$0.00
Warrant No.
Check No.
NET AMOUNT DUE TO STATE
$0.00
Warrant Date
Check Date
Statewide Doc. Date
Agency Voucher
Pursuant to Section 112.061(3)(a), Florida Statutes, I hereby certify or affirm that to the best of m y knowledge the above travel was on official
business of the State of Florida and was performed for the purpose(s) stated above.
Agency Voucher No.
$0.00
Supervisor's Signature
I hereby certify or affirm that the above expenses were actually incurred by me as necessary travel expenses in the performance of m y official duties;
attendance at a conference or convention was directly related to official duties of the agency; any meals or lodging included in a conference or convention
Signature Date
registration fee have been deducted from this travel claim; and that this claim is true and correct in every material matter and same conforms in every respect
with the requirements of Section 112.061, Florida Statutes.
Supervisor's Title
Traveler's Signature
Prepared By
Signature Date:
Title:
Phone\Suncom Number
\
FA001
Revised 01/26/07
Save As
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TRAVELER
PEOPLE FIRST ID#
Travel Performed By Common Carrier Or State Vehicle
NOTE: If travel was performed by common Carrier and paid for personally, receipt must be furnished
Ticket Number or
Name of Common Carrier or
Date
FROM
TO
Amount
State Agency Owning Vehicle
State Vehicle Number
STATE OF FLORIDA PURCHASING CARD CHARGES
THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN TRAVEL RELATED EXPENSES ARE PAID USING THE STATE OF FLORIDA PURCHASING CARD
Date
Merchant/Vendor
Description of Item Acquired
Amount
$0.00
Total Purchasing Card Reimbursable Charges
$0.00
THIS SECTION REQUIRED TO BE COMPLETED ONLY WHEN NON-REIMBURSABLE ITEMS WERE PURCHASED USING THE STATE OF FLORIDA PURCHASING CARD
Date
Merchant/Vendor
Description of Item Acquired
Amount
$0.00
$0.00
(THIS AMOUNT MUST APPEAR ON THE LINE "LESS NON-REIMBURSABLE ITEMS INCLUDED ON PURCHASING CARD:" ON THE REVERSE SIDE OF THIS
Statement of Benefits to the State (Conference or Convention)
Page 2
PEOPLE FIRST ID#
TRAVELER
SOCIAL SECURITY NO.
Hour of
Class
Actual
Per
Class
Map
Vicinity
Incidental Expenses
Travel Performed From
Purpose or Reason
Depart &
A and B
Lodging
Diem
C
Mileage
Mileage
Date
Point of Origin to Destination
(Name of Conference)
Return
Meals
Expenses
Meals
Claimed
Claimed
Amount
Type
$0.00
$0.00
$0.00
0
0
$0.00
Amount
Air Fare
Page 3
SUBTOTALS
$0.00
$0.00
$0.00
0
0
$0.00
$0.00
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Page of 3