FormFlow 1.00P12 IDNumber @. "IDReqCh@  5 5"  5 5 Othert @ ʨ52ʨ5" ਷5਷5 NFCReply @ 535" 55 AuthSig @ J55J5" `5`5 Titlet @ 56 5"  5 5 Phonet @ ʫ57ʫ5" ૷5૷5 Datelt E/ 585" 55 CasTime@ J5J5" `5`5 Uniform@  5 5"  5 5 InfoOth@ ʮ5ʮ5" ஷ5ஷ5 DocNumb@ 5-5" 55 NonRecp@ J5J5" `5`5 Furnish@  5 5"  5 5 AppNumb@ ʱ5+ʱ5" ౷5౷5 PayStat@ <5<5" R5R5 NonRCh@ 55" 55 BillNumb@ 5)5" Ҵ5Ҵ5 PhoneNon@ |5!|5" 55 Bondlt@ <5<5" R5R5 Payroll@ 5 5" 55 NonRecCa@ 5&5" ҷ5ҷ5 RecAgcy@ |5|5" 55 StFMCh@ <5<5" R5R5 BillingSt@ 5'5" 55 MastFile@ 5 5" Һ5Һ5 NonRec@ |5|5" 55 W2ult@ <5 <5" R5R5 MastFileF@ 5%5" 55 InqCode @. "ReplyCode @. "DateRec E/ "DateComp E/ "Clerkt @. "AccStID @. "Namelt @.  "SchedNo @.  "OtherCh@ ~÷51~÷5" ÷5÷5 AgcyCode @. "TypeRep @. /"RepDate E/ 0"MailTo @ $Ʒ54$Ʒ5" :Ʒ5:Ʒ5 TypeInq@ Ʒ5 Ʒ5" Ʒ5Ʒ5 OthInS @. "ReAgBalCB. "DateAd E/ "FedStatus @. "StatusFN @. "Subvouch @. "GBLStatus @. "POStatus @. ""OTCStatus @. #"MiscStatus @. $"BillStatus @. ("BillNum @. *"AppNum @. ,"DocNum @. ."Swiss"Arial"Univers (WN)#Univers Condensed"CG Times (WN)Univers Cd (W1)"""""ZaHH $>c18cԔp )D[o7:$3Z.0a 6G4;G46G4;G4BILL NUMBER $:ų3Zc.0a 7G4&;G47G4;G4APPLICANT/DEBTOR NUMBER Ƴ:'3ZcC.0a .9G48ܷ5O>PAYMENT STATUS OF o7M3s0aV8*;>V8;>RECONCILE, AGENCY BALANCE IS:v'F{s6Cn03 a '3sC0   `շ5`շ5ųv'c6Cv0a  OthInS >-8>8OTHERE (Explain Below)E Qvų6cv0a .5f8.5f8UNIFORM vQ6v0a R.58R.58CASUAL TIMEn7v 6v0a -5F>-5F>PAYROLL LISTING FOR YEAR(S)/88B8> >^5/88-5/88B8vn7s6v0a ,5>,5>W-2 FOR TAX YEARG(pUkveF0a8888INQUIRY CODE (3)`DF(v&e0a8F88F8AGENCY CODE (2) `DF(v&e0a  AgcyCode  eP&fP eP&fP kpUvFX0aX88X88REPLY CODE (2)kpUvFX0a  ReplyCode hPhPhPhP G(pUkveF0a  InqCode fPgPfPgP N'7C0a758758NON-RECEIPT OF PAYMENTo7#+0a ܷ5";>ܷ5;> TRAVEL COUCHER/ADVANCEo71s0a  ReAgBal 8888 o7:$3Z.0a  BillNum EG4>EG4> $:ų3Zc.0a  AppNum ,8>,8> Ƴ:'3ZcC.0a  DocNum (DG4V>(DG4V> suo7ss0a   StatusFN 8$ 88 8STATUS OF FORM NUMBER <vߪF{6sn03 a <7ߪus0   ׷5׷5ط5d >ط5d >ٷ5M>ٷ5M>ٷ5>ٷ5>.ٷ5>.ٷ5>Hٷ5>Hٷ5>Zٷ5>Zٷ5>lٷ5<>lٷ5<>ٷ5>ٷ5>ٷ5&>ٷ5>ٷ5>ٷ5>ٷ5">ٷ5">ٷ5>ٷ5>ڷ58ڷ58Salary/ AllowanceCheck/BondTravel Voucher/AdvanceFEDSTRIP Motor PoolGBL/GTR/CBLImprest FundTelephone/ UtilitiesPurchase Order (AD-838)Over-the-Counter Purchase (AD-744)Misc. PayGasoline Credit CardBillings/ CollectionsCAS/Agency Reporting$su'sC0a  Subvouch T86>T8>FURNISH (SUB)VOUCHERS FOR AUDIT PERIOD n7sv0a 8#M>8M>NON-RECEIPT E(Check one)En7'vC0a  ۷5VN>۷5VN>BONDg}3 pa̠  ;{aDyVUXa`#'DC&a  ݷ5N>ݷ5N>REQUEST FOR INFORMATION#5%_]4n0a ޷5N>޷5N>IDENTIFICATION NUMBER#]4_1XnK0a ߷5CZO> ߷5ZO>SOCIAL SECURITY, ACCOUNT, BOAC, GBL, GTR, PURCHASE ORDER, ETC.#2X_vnK0a  IDNumber #v_n0a<524><54>IDENTIFICATION REQUESTED. PLEASE FURNISH COPY.#~>n0a  IDReqCh #F{')nnCV0a  Other l8H8l88OTHERE (If more space is required, add additional sheet(s).)E #*'BnVC1a  NFCReply 258258NFC REPLY 7B'sC0a  AuthSig 688688AUTHORIZED SIGNATURE 7'sC0a  Title ^5p8^5p8TITLE 7'XsC=0a  Phone 8)888PHONE E(Area Code and number)E 7X' s=C{0a  Date 5֭85֭8DATE 488B8> >^5/8858ޛ488B8#v<F{n6n03 a #v<7n6u0  TypeInq  P5P5 >xPv0a  CasTime Q=\iPv0a  Uniform Ƴ=2cPv0a  InfoOth ųF14Zc.0a   DocNumb AG4AG4$ N3@0a   NonRecp #ہ@0a   Furnish #F5Z @.0a   AppNumb CG4CG4p7 NL30a   PayStat o7ہN$0a   NonRCh o7FN5Z .0a   BillNumb o7N70a   PhoneNon o7QN:0a   Bond o7?NQv0a  Payroll o78'N:0a   NonRecCa  M4s0a   RecAgcy ځLs0a   StFMCh FL4Zs.0a   BillingSt L6s0a   MastFile PL:s0a   NonRec >LsPv0a  W2 7'L:s0a   MastFileF #ߪuns60a 5<>5<> TYPE INQUIRYG(DųpUe&cF0a ?>\>>?>\>>FOR OFM/NFC USE ONLYpU$vXF0a  DateRec kP|8kP|8DATE REC'D. (6) $pUfvF0a  DateComp 8̬88̬8DATE COMP. (6) fpUųvFc0a  Clerk 8(88(8CLERK CD. (2) ųa'vc^C0a  AccStID ųD'dc&Cc0a 52858ACCT. STATION/ PERSONNEL OFFICE IDENTIFIER (4)`vųc0a  Name 8I$>8$>NAME E(Employee, Vendor, Traveler, Cashier, Claimant, Casual)E dzv'cC0a  SchedNo b>8b>8SCHEDULE/PP NO. #'nC0a  `5>`5> E EP INSTRUCTIONSPE Check type inquiry and information requested. If information requested is not described below, check type inquiry and briefly describe information requested in the "Other" block. Always attach a copy of the source document pertaining to the inquiry for identification and follow-up.ߪ'usC60a 4 5>4 5>INFORMATION REQUESTED:88B8> >^5/884 58ޛ,4 :88B8#G{<unn0a  OtherCh z-z-R.4Z$F{s.n0a  TypeRep  8(8 8(8TYPE REPORT $4Z'F{.Cn0a  RepDate \8p8\8p8REPORT DATE f}2 pa  MailTo 8 88 8 ]4e} pa +58+58AGENCY NAME AND ADDRESSEyG(g}D} a R,5R8R,5R8MAIL REPLY TO:[L3@a b058b058NON- RECEIPTT'#$C0a 05'L805L8DATE OF ADVANCE OR PERIOD OF TRAVEL[&$'4Ca  DateAd 4'_TsC30a  FedStatus 156 >156 >STATUS Npu#s0a\25 8\25 8NON-RECEIPT OF PAYMENTNo770a 258258MASTER FILE ERROR_T'pus3Cs0a  GBLStatus f35ܴ8f35ܴ8STATUS 8'IsC00a  POStatus 35$835$8STATUS I'Zs0Cp0a  OTCStatus 45l845l8STATUS Z'kspCa  MiscStatus 558558STATUS Mpo7:0ah658h658REQUEST FOR MASTER FILENp':C0a65ֶ865ֶ8NON-RECEIPT OF CREDIT CARDN:o73Z.0a  BillStatus ~758~758STATUS S ' {CX E>E>E>E>FORM AD-354 (Rev. 9/93)