Final Personnel Record for Newhouse, Delbert C., U.S. Navy, 1957

Text

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VOUCHER FOR REIMBURSEMENT FOR TRAVEL
(DEPENDENTS OF MILITARY PERSONNEL) | D.O. VOUCHER NO.
17288
DEPARTMENT, BUREAU OR ESTABLISHMENT.
NAVY DEPARTMENT | BUREAU VOUCHER NO.
1801
PAYEE (Name)
Bellaart C. NEUHOUSE, USN, 177293 | (Rank or rate)
(File or Service, No.)
MAILING ADDRESS
USNAS PENSACOLA, FLORIDA | PAID BY
W E DODDY
OFFICIAL DUTY STATION
NAS PENSACOLA, FLORIDA | AUG 6 1956
CERTIFICATION OF CLAIMANT
Payment is requested for travel by persons listed below who were establishing a bona-fide residence. (If any of these be other than a lawful wife or unmarried legitimate child under 21 years of age or a MALE member, complete appropriate certificate on reverse.)
NAME | RELATIONSHIP | BIRTH DATES OF CHILDREN |
Bellaart C. NEUHOUSE | wife |  |
Bellaart C. NEUHOUSE | son | 6-28-38 |
Anne Listet NEUHOUSE | daughter | 3-14-40 |
LOCATION OF DEPENDENTS (On date of receipt of orders/authority, street address, city, state) |  | DATE OF DEPARTURE |
3501 50th Street, Portland, Oregon |  | 7-1-56 |
DESIGNATED DESTINATION OF DEPENDENTS (If other than Portland, Oregon) |  | DATE OF ARRIVAL |
736 Lakewood Road, Carvington, Va. |  | 5-2-56 |
NOTE: When travel is from other than vicinity of the old station or to other than vicinity of the new station, explain circumstances on the reverse.
GOVERNMENT TRANSPORTATION FURNISHED | KIND (Rail, air, etc. If none, so state) | DESTINATION (Date of arrival) |
 | PLACE OF DEPARTURE (Date of departure) |  |
TRAVEL COVERED BY THIS CLAIM REPRESENTS ENTIRE TRAVEL OF ALL MY DEPENDENTS ON THIS CHANGE OF STATION EXCEPT:
ALL DEPENDENTS OF MY FAMILY FOR THE TRAVEL OF DEPENDENTS AS CLAIMED HEREIN.
PENALTY FOR PRESENTING FRAUDULENT CLAIM — Fine of not more than $10,000 or Imprisonment for not more than 5 years or both. Title 18, U.S.C. 287; id. 1001. | FORFEITURE OF FRAUDULENT CLAIM — Falsification of an item in an expense account works a forfeiture of the claim. Title 28, U.S.C. 2514.
SIGN OR CERTIFY, that this voucher and attachments are correct and just in all respects and that payment therefor has not been received. No prior claim has been presented by me or any member of my family for the travel of dependents as claimed herein. | DATE:
SIGNATURE OF PAYEE: A.C. Neushouse | DATE: 8-3-56
AUTHORIZED ALLOWANCE (From) J.B. LT C. NEUHOUSE (To) | APPROVED FOR $
MILEAGE: 2600 mi 3 1/2 adults (1 child) | Pursuant to authority vested in me, I certify this voucher to be correct and proper for payment.
AUTHORIZED CERTIFYING OFFICER: P. E. DODDY, ACCOUNTING CLASSIFICATION 4 | DATE: 8-3-56
Appropriation Symbol and Subhead | Object Class | Expenditure Account | Chargeable Activity | Bureau Control Activity No. | Bureau Control No. | Amount
17 1453.18 MPN 56 | 020 | 7350 |  | 22 | 81600 |
PAID BY CHECK | PAID BY CASH | SIGNATURE OF PAYEE (Required for cash payment only) |
Check number:
Date of check: | Amount:
Date paid: |  |
444.00 |  |  |

DD FORM 766

1 APR 94 766 REPLACES NAV. S. AND AV FORMS 2072 & 913, FC-107, NAVMG 179-9D & 1770-SD

MEMORANDUM FOR DISPOSAL

Form Approved by
Comptroller General, L.S.
March 15, 1954