number relationship dob except % date of arrival spouse support at post (mm/dd/yy) relationship dob except % date of spouse support departure (mm/dd/y...
Interagency Appraisal and Evaluation Guidelines I. Purpose The Office of the Comptroller of the Currency (OCC), the Board of Governors of the
Business Hours: 8:30 am - 17:00 pm CET . IMPORTANT Please fill out this order form in its entirety. Click the "Submit" button to send your voucher order
BYPASSES / DISABLES System Disables -500 and 510 501 Access reader disable Zone Sounder / Relay Disables -520 520 Sounder/Relay Disable Zone 521 Bell 1 disable Zone
46 Hysan Annual Report 2016 Risk Management and Internal Control Report Since 2012, we have put in place a phased improvement plan and progressed to further
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Interagency cooperation in disaster management: partnership, information and communications technology and committed individuals in Jamaica By Ina Østensvig
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NUMBER APROX. YR NUMBER APROX. YR 80,871-100,499 100,500- 1995 (Continued) No numbers
Table of Contents Second-Grade Module: Number and Number Sense Comparing Numbers with Base-10 Blocks
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49 Chapter 3 The Foreign Exchange Market The foreign exchange market (FX market) is the market on which different cur-rencies are traded against one another
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Investors who own Canadian mutual funds and who file U.S. tax returns will be affected by PFIC rules. Note that all U.S. citizens and green card holders are required
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2 Democratic People’s Republic of Korea (DPRK) and Vietnam, two neighboring countries having friendly relations with China. Following the Asian-African
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MSE 5301, Interagency Disaster Management 7. Ask the Professor: This communication forum provides you with an opportunity to ask your professor general or
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E. 164 –NUMBER STRUCTURE Specifically ITU-T Recommendation E.164 - the International public telecommunication numbering plan defines the number structure and
FOREIGN ALLOWANCES APPLICATION, GRANT AND REPORT
INTERAGENCY REPORT CONTROL NUMBER
VOUCHER NUMBER
1170-DOS-AN
1. EMPLOYEE NAME (LAST, FIRST, MIDDLE INITIAL)
2. SOCIAL SECURITY NUMBER
3. AGENCY
4. AUTHORIZATION/GRANT NUMBER
5. PAY PLAN/SERIES/GRADE/ANNUAL SALARY
6. POSITION TITLE
7. CURRENT POST/COUNTRY OF ASSIGNMENT/LOCALITY CODE
8. DATE OF ARRIVAL
9. PREVIOUS POST OF ASSIGNMENT
10. MAILING ADDRESS 11. IF LOCAL HIRE: DATE OF ARRIVAL AT POST/REASON FOR PRESENCE 12. IF SPOUSE IS EMPLOYED BY THE US GOVERNMENT: NAME/SOCIAL SECURITY NUMBER/ALLOWANCES RECEIVED
Active Duty
US Civilian
13. FAMILY DOMICILED AT POST NAME OF RELATIVE
RELATIONSHIP
DOB EXCEPT SPOUSE (MM/DD/YY)
% SUPPORT
DATE OF ARRIVAL AT POST
RESIDENCE ADDRESS
DOB EXCEPT SPOUSE (MM/DD/YY)
% SUPPORT
DATE OF DEPARTURE FROM POST
RESIDENCE ADDRESS
14. FAMILY DOMICILED AWAY FROM POST NAME OF RELATIVE
RELATIONSHIP
15. REMARKS
Privacy Act Statement: Solicitation of this information is authorized under 5 U.S.C. 5922, E.O. 9397 and E.O. 10903, Section 1(b-2) and DSSR Section 073.4 The information is used to determine employee eligibility for and appropriate amounts of allowances. All forms are subject to fiscal audit by the employee's parent agency and GAO. The Office of Allowances, U.S. Department of State, will review forms to set LQA rates. Lack of requested information may result in erroneous or unauthorized allowances. 7540-00-782-3836
STANDARD FORM 1190
(REV. 1/98)
PAGE 1 OF 2
DEPARTMENT OF STATE STANDARDIZED REGULATIONS (DSSR) (GOVERNMENT CIVILIANS, FOREIGN AREAS), SECTION 073.4
VOUCHER NUMBER
FOREIGN ALLOWANCES APPLICATION, GRANT AND REPORT 16. EMPLOYEE NAME (LAST, FIRST, MIDDLE INITIAL)
17. SOCIAL SECURITY NUMBER
18a. PAYMENTS/ENTITLEMENTS (Check box(es). For calculations see DSSR chapter exhibits.)
TRANSFER ALLOWANCE: Foreign ( Portion(s): Subsistence (
________ # of Months
________
$
Foreign Curency Payment ) Miscellaneous (
) or Home Service (
) Wardrobe (
) Lease Penalty (
) )
ADVANCE OF PAY (DSSR 850) This advance will be repaid in _________________ pay periods. Travel Authorization or Permanent Change of Station (PCS) Number Name of Issuing Activity
METHOD OF PAYMENT 19a. If Electronic Funds Transfer (EFT)
Mark one:
(
) Checking
(
) Savings
FINANCIAL INSTITUTION NAME
FINANCIAL INSTITUTION MAILING ADDRESS
ROUTING NUMBER
ACCOUNT NUMBER (including any suffix)
19b. IF BY CHECK CHECK MAILING STREET ADDRESS CHECK MAILING CITY, STATE, ZIP CODE 20. ACCOUNTING CLASSIFICATION(S):
21. Employee Statement and Signature: The information given on this application is true and correct to the best of my knowledge and belief. I also understand that I am obligated to notify the authorizing office immediately of any change in conditions which may affect the amount of allowances and/or differential authoraied herein. I also understand that false statements made to the United States on this form may subject me to crimnal penalties (including fines and imprisonment) under 18 U.S.C. 287 and 1001 and/or civil penalties under 31 U.S.C. 3729 or administrative penalties under 31 U.S.C. 3802. I understand if my employment is terminated prior to liquidation of any of these advances, any outstanding amount is due and payable immediately.
EMPLOYEE'S SIGNATURE:
DATE:
22. APPROVING/REVIEWING OFFICIAL SIGNATURE WHEN REQUIRED: DATE: 23. CERTIFYING OFFICIAL: THE ABOVE REQUEST IS CERTIFIED AS CORRECT AND PROPER FOR PAYMENT AUTHORIZED CERTIFYING OFFICIAL'S SIGNATURE: