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["NOT TO BE USED BY REGION OR WING TO SUBMIT EXPENSES TO NATIONAL HEADQUARTERS"]
["Region/Wing refer to Web Mission Information Reporting System (WMIRS)"]
["REIMBURSEMENT FOR INDIVIDUAL CAP MEMBER EXPENSES"]
["For instructions and help, place mouse pointer on triangles (red)."]
["1.  Mission Number:",{"$nulls":4},"Start Date (dd/mmm/yy):",{"$nulls":3},"Stop Date (dd/mmm/yy):"]
["2.  Type Mission:",{"$nulls":6},"3.  Claimant (See Instructions on Reverse)"]
[]
["4A.  Mailing Address:",null,null,"          Check here if new address",{"$nulls":6},"4B. Phone Number and E-Mail Address:"]
[]
[]
["5.  Invoice (Refer to Instructions):"]
["A. DATE","B. TYPE ACFT","C.  ACFT ","D. ACFT","E. ACFT/",null,"F. HOURS","G. HOURLY","H. ACFT","I. FUEL AND","J. LODGING &","K. COMM/","L. SUB"]
["(dd/mmm/yy)","OR VEH","HP","ID/VEH ID OR","VEH OWNER",null,"FLOWN/","RATE ACFT","COST","OIL COST","PER DIEM","OTHER COST","TOTAL"]
[null,"MAKE/MODEL",null,"LICENSE","Corp","Mbr","NO. MILES","MINOR MX","CLAIMED"," CLAIMED","COST CLAIMED","CLAIMED","CLAIMED"]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
[{"$nulls":8},0,{"$nulls":3},0]
["TOTAL CLAIMED BY CATEGORY",{"$nulls":7},"6. ACFT COST","7. FUEL/OIL","8. L & PD","9. OTHER","10. TOTAL"]
[{"$nulls":8},0,0,0,0,0]
["11.  CERTIFICATIONS. The parties signing in Blocks 11A and 11B are responsible for the accuracy and validity of the facts recited in the claims"]
["and supporting documentation.  The parties shall not claim costs on the CAPF 108 if expenses are being reimbursed from another source."]
["Dual compensation is prohibited."]
["11A.  CAP MEMBER:  I CERTIFY THAT THE AMOUNTS PAID WERE FOR PARTICIPATION IN THE LISTED USAF AUTHORIZED MISSION AND ACCURATELY REFLECT HOURS FLOWN, AUTOMOTIVE FUEL/OIL USED, AND /OR OTHER MISCELLANEOUS COSTS INCURRED.  (Please print/type name below signature.)",{"$nulls":8},"SIGNATURE AND DATE"]
[]
[]
["11B.  WING APROVAL:  I CERTIFY THAT THE AMOUNTS PAID WERE FOR PARTICIPATION IN THE LISTED USAF AUTHORIZED MISSION AND ACCURATELY REFLECT HOURS FLOWN, AUTOMOTIVE FUEL/OIL USED, AND /OR OTHER MISCELLANEOUS COSTS INCURRED.  (Please print/type name below signature.)",{"$nulls":8},"SIGNATURE AND DATE"]
[]
[]
["CIVIL PENALTY FOR PRESENTING FRAUDULENT CLAIM.",{"$nulls":8},"CRIMINAL PENALTY FOR PRESENTING FRAUDULENT CLAIM."]
["“THE CLAIMANT SHALL FORFEIT AND PAY TO THE UNITED STATES THE SUM OF FIVE TO TEN",{"$nulls":8},"“FINE OF NOT MORE THAN TEN THOUSAND DOLLARS OR NOT  "]
["THOUSAND DOLLARS PLUS THREE TIMES THE AMOUNT OF DAMAGES SUSTAINED BY THE ",{"$nulls":8},"MORE THAN FIVE YEARS IN PRISON OR BOTH.”(SEE 18 U.S.C. 287)    "]
["UNITED STATES.”  (SEE 31 U.S.C. 3729)     (APPLICABLE TO ALL SIGNATORIES)",{"$nulls":8}," (APPLICABLE TO ALL SIGNATORIES)"]
["CAP FORM 108, APR 07.    Corrected Copy      PREVIOUS EDITIONS WILL NOT BE USED.   THIS FORM CANNOT BE MODIFIED.                            OPR/ROUTING:  MD"]
[]
[]
["INSTRUCTIONS FOR COMPLETING THE CAPF 108",{"$nulls":3},"Consult with CAP-USAF/SE; other safety discussions with NHQ SE staff. "]
["· All pilots flying on USAF authorized reimbursable missions MUST SUBMIT appropriate documentation to the wing showing aircraft flown, ownership, and "]
["   flying time even if no individual claim for reimbursement is made.  This information is required for statistical purposes."]
["· This documentation and appropriate receipts must be submitted to the wing not later than 15 days after the close of the mission. "]
["· Wings must prepare a consolidated mission WMIRS CAPF 108 through WMIRS to the National Operations Center not later than 30 days after the close of the mission."]
[]
["BLOCK 1.","Enter mission number and mission inclusive dates.  Add sequential alpha character to adjustment claims."]
["BLOCK 2.","Check the appropriate block for the type mission, one block only!  "]
[null,"If \"Other,\" describe."]
["BLOCK 3.","For individual list full name and CAPID.  For unit list charter number, i.e., GLR-MI-051."]
["BLOCKS 4A & 4B.",null,null,"Enter appropriate mailing address, phone number and e-mail address for entry in block 3."]
["BLOCK 5.","Check the appropriate block to identify if this is a partial or the final claim for the mission (block 1).   "]
[null,"NOTE: A separate line entry must be made for each aircraft/vehicle unitized."]
["BLOCK 5A.","Enter date expense incurred (as shown on receipt)."]
["BLOCK 5B.","Enter the type of aircraft or vehicle make and model."]
["BLOCK 5C.","Enter aircraft horsepower (hp)."]
["BLOCK 5D.","Enter the aircraft registry number or, for corporate-owned vehicles (COV), the vehicle identification number or, for private-owned"]
[null,"vehicles (POV), the vehicle license plate number corresponding to 5B."]
["BLOCK 5E.","Check appropriate block to identify entry in 5B."]
["BLOCK 5F.","Enter aircraft hours(hobbs) flown or number of miles driven for entry in 5B."]
["BLOCK 5G.","Enter the hourly aircraft minor maintenance rate for aircraft type entered in 5B.  Reference current rates published in CAPR 173-3."]
["BLOCK 5H.","Multiply the entry in 5F by 5G and enter the result."]
["BLOCK 5I.","Enter the amount claimed for the entry in 5B and attach original receipt(s)."]
["BLOCK 5J.","Enter amounts claimed for lodging and per diem costs and attach original receipt(s)."]
["BLOCK 5K.","Enter amounts claimed for communications cost, aircraft oxygen service, authorized TDY expenses, etc., and attach original receipt(s)."]
["BLOCK 5L.","Enter the sum of 5H through 5K as appropriate."]
["BLOCK 6.","Enter the total of column H."]
["BLOCK 7.","Enter the total of column I."]
["BLOCK 8.","Enter the total of column J."]
["BLOCK 9.","Enter the total of column K."]
["BLOCK 10.","Enter the total of entries in blocks 6 through 9 OR  total of column 5L (both should be equal)."]
["BLOCKS 11","Read, print/type name, sign and date."]
["CAP FORM 108, APR 07    Corrected Copy           Reverse"]